Nominate A Child

Do you know a child who deserves to go to Disney Land? Please review our Child Criteria and then enter the information below. Please note that submissions will only be accepted until MARCH 20, 2020.

Tell Us About You
Your Name*
First Last
Your Email Address*
Just in case we need to get a hold of you.
Your Number*
Tell Us About The Child
Please fill in the fields as best you can.
Child's Name*
First Last
Main Parent or Legal Guardian Name*
Phone*
Primary contact number for Main Parent or Legal Guardian
Email
If available email address for Main Parent or Legal Guardian
Enter Email Confirm Email
Address
Street Address Address Line 2 City Province Postal Code
Child's Birth Date*
Date Format: MM slash DD slash YYYY
Why do you want to nominate this child?*
Does this child have any special needs?*
- No
- Yes
If "Yes" please describe below
If the answer above is "Yes", please use this space to provide more information.
Is the main Guardian of this child aware of this nomination?*
- No
- Yes
Consent*
I have read and understand the Child Criteria.*
I have verified that the child being nominated has not been to a commercial theme park as of the date of this nomination:*
Custody Status*
Please describe the Custody Status of this child.
If you have a letter in support of this child's nomination, please feel free to upload it here.
Letter can be from yourself or another member of the community that knows this child. It is helpful for the child selection process if the letter provides as much information as possible to support this child's nomination
Accepted file types: jpg, gif, png, pdf, doc, docx.
Comments
This field is for validation purposes and should be left unchanged.

Nominate A Child

Tell Us About You

Tell Us About The Child

Dreams Take Flight | Edmonton

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