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Female, Age 11 - Family 79

  1. Due to the overwhelming support of our Make a Child Smile Event, the child you selected may have already been adopted by another family. If this is the case you will receive notification from us within 48 business hours with a similar child's information.
  2. Child Identification

    Female, Age 11 

  3. Family Number


  4. Shirt Size

    Youth Medium

  5. Pants Size

    Youth Size 9-10

  6. Shoe Size

    Youth Size 5.5

  7. Needs


  8. Gift of Choice/Favorites

    white or pink crocs/Nike

  9. Leave This Blank:

  10. This field is not part of the form submission.