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Male, Age 15 - Family 53

  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

    Male, Age 15 

  3. Family Number


  4. Shirt Size

    Youth 16

  5. Pants Size

    Youth 14-16

  6. Shoe Size

    Adult Size 10.5

  7. Needs


  8. Gift of Choice/Favorites

    soccer/track/wants a PS4 remote/video headphones

  9. Leave This Blank:

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