Santa’s Blazin’ Sleigh Bells (Shop with a Firefighter )

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

Nominator

Details of the person submiting the nomination.

Your Name *

First

Last

Organization or Agency (if applicable)

- YES Nominator

Phone

Email *

Child's Information

Details about the child being nominated.

Child's Name *

First

Last

School & Grade

Gender

Parent / Guardian's Information

Parent Guardian's Name *

First

Last

Relationship to child

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Number of children in the home

Ages of children in the home

Have your child participated with Shop with a Firefighter before?

If YES - when

Why 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.

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Nominator

Child's Information

Parent / Guardian's Information

Shift Schedule

Links

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