Childhood Cancer Foundation of Southern California invites you and your children to the 33rd Annual Christmas Celebration. As in the previous years, we will provide Arts and Crafts, Entertainment, and a visit from Santa Claus.

Each year this celebration increases in size, we are requiring a ticket per child and adult for entrance. These tickets will be available for immediate family members only, brothers and sisters of the patient. Please complete below questionnaire for your tickets.  YOU MUST PROVIDE AN EMAIL TO RECEIVE TICKETS TO THE PARTY.


       
Patient's First Name: *



Patient's Last Name: *



Gender: *
  • Male
  • Female
Age: *
       
 Brothers / Sisters
     
First Name:



Last Name:



Gender:
  • Male
  • Female
Age:



First Name:



Last Name:



Gender:
  • Male
  • Female
Age:


First Name:



Last Name:



Gender:
  • Male
  • Female
Age:


First Name:



Last Name:



Gender:
  • Male
  • Female
Age:


First Name:



Last Name:



Gender:
  • Male
  • Female
Age:


       
       
Number of Adults: *
Email: *
Phone Number: *
 
Address: *
City: *
Zip Code: *