Celebrations Club Request Form

This section should include the information of the person submitting the request on behalf of the child/youth (You):

This section includes information about the child in which you are submitting the request.

This section provides background on the child/youth's current Caregiver

This section contains information on the Department of Social Services Assigned Case Worker

This section includes information specific to your request. Please be as detailed as possible as to your request.

Please indicate that you certify the following information:

Members & Volunteers