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Male, Age 17 - Family 65

  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 17 

  3. Family Number


  4. Shirt Size

    Adult Small shirts/Hoodies M

  5. Pants Size

    Adult Small

  6. Shoe Size

    Adult Size 12

  7. Needs


  8. Gift of Choice/Favorites

    Football player/video games

  9. Leave This Blank:

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