Christmas Family Fun Box Order Form

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First Name

Last Name

Email address

Address

Phone number

How many children do you have in each age category?

Newborn to 2 years old

3 to 5 years old

6 to 12 years old

I paid for my box using the Add to Cart button at https://wejh.ca/family-fun-boxes

YES

Please select the pick-up location and date for your Family Fun Box pick-up:

Important note: For the Sainte-Foy and Beauport pick-ups we will email you a specific pick-up time between 10am-12pm on December 11th and the specific address for pick-up when your order is ready. If you absolutely cannot come get your Family Fun Box during the above times, please let us know by sending an email to: jprice@jhpartners.net

I'd like to receive email communications from Jeffery Hale Community Partners and the Wellness Centre. I understand I can withdraw my consent to receive email communications at any time. For more details, contact info@jhpartners.net

YES

Thank you for your purchasing a Family Fun Box and supporting the Community Christmas Hamper Campaign. We wish you a joyful holiday season!

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