Santa’s Blazin’ Sleigh Bells – Child Nomination Form Event Date: Saturday, December 13, 2025 Event Location: Walmart of Show Low Nominations must be submitted by November 30, 2025 Please enable JavaScript in your browser to complete this form.NominatorDetails of the person submiting the nomination.Your Name *FirstLastOrganization or Agency (if applicable)PhoneEmail *Child's InformationDetails about the child being nominated.Child's Name *FirstLastSchool & GradeGenderMaleFemaleParent / Guardian's InformationParent Guardian's Name *FirstLastRelationship to child Email Nominator Relationship AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmail *Number of children in the homeAges of children in the homeHave your child participated with Shop with a Firefighter before?YesNoIf YES – whenWhy are you nominating this child? *Signature * Clear Signature I certify that the information provided is true and accurate to the best of my knowledge. I understand that submission of this form does not guarantee selection and that photos may be taken during the event for promotional use.Submit