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951-801-5674
951-275-5000
info@codie.org
1737 Atlanta Ave, #H3A, Riverside, CA 92507
M-F, 8:30 am - 12 pm, 1 pm - 5pm
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LifeSigns, Inc
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Privacy
Complaint
Services
Family Outreach Advocates
HH&LD
PTS
Employment Assistance
Events
Go to Events
Children’s Holiday Drive-Thru
Open Caption Movies
Love & Literacy
Resources
Wellness
Careers
LifeSigns, Inc
Contact
Media Relations
Book Appointment
Test: Children’s Holiday event
2022 Children’s Holiday Drive Thru
Registration Form
Information about your children
Your first child's name
(Required)
First Name
Your first child's age
(Required)
Your first child's gender
(Required)
Non-Binary
Girl
Boy
Your second child's name
First Name
Your second child's age
Your second child's gender
Non-Binary
Girl
Boy
For large family
Do you have more than two children?
(Required)
Yes
No
How many children do you have?
3
4
5
More than 6
Your third, fourth, fifth…childrens' first name(s), ages, and gender.
Example: John Doe, Jr., 3, Male Jane Doe, 10, Female Harry Doe, 12, Non-Binary
Parent / Guardian's Information
Parent's / Guardian's Name
(Required)
First Name
Last Name
Email
(Required)
Please contact us at 951-801-5674 videophone, 951-275-5000 voice if you don’t have an email.
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