Back to School Rally Registration
Join us at Hawkeye Downs on Saturday, August 3 from 12 pm to 4 pm for our 2019 Back to School Rally. This year, we will be using a new fill your own backpack format. Please bring a printed out or digital copy of your kiddos' school supply lists.

This event is free to attend for Iowa’s children in foster care, relative placement or adopted from foster care. ALL FIELDS ARE REQUIRED FOR EACH CHILD.

After completing this form, you will receive a confirmation email. Please bring your confirmation email to the event as your proof of registration. If you have more than five children, please fill out this form a second time, and please only list each child once. Registration will close on July 31, 2019.

If you have any additional questions, please contact our office at 319-294-9706 or office@fhfia.org.

Email address *
Caregiver First Name *
Your answer
Caregiver Last Name *
Your answer
Caregiver Street Address *
Your answer
Caregiver City *
Your answer
Caregiver State *
Caregiver Zip Code *
Your answer
Caregiver County *
Caregiver Phone Number *
Your answer
First Child Information
First Child First Initial
Your answer
First Child Last Initial
Your answer
First Child Medicaid ID Number
Without this number, we will not be able to provide a backpack for your kiddo.
Your answer
First Child Gender
First Child Status
First Child Age
Age after August 1, 2019
Your answer
First Child Grade
Grade that they will start in the fall.
First Child School
Your answer
First Child School District
Your answer
Second Child Information
If you have fewer than two children requiring school supplies, please leave the rest of this form blank.
Second Child First Initial
Your answer
Second Child Last Initial
Your answer
Second Child Medicaid ID Number
Without this number, we will not be able to provide a backpack for your kiddo.
Your answer
Second Child Gender
Second Child Status
Second Child Grade
Grade that they will start in the fall.
Second Child School
Your answer
Second Child School District
Your answer
Third Child Information
If you have fewer than three children requiring school supplies, please leave the rest of this form blank.
Third Child First Initial
Your answer
Third Child Last Initial
Your answer
Third Child Medicaid ID Number
Without this number, we will not be able to provide a backpack for your kiddo.
Your answer
Third Child Gender
Third Child Status
Third Child Grade
Grade that they will start in the fall.
Third Child School
Your answer
Third Child School District
Your answer
Fourth Child Information
If you have fewer than four children requiring school supplies, please leave the rest of this form blank.
Fourth Child First Initial
Your answer
Fourth Child Last Initial
Your answer
Fourth Child Medicaid ID Number
Without this number, we will not be able to provide a backpack for your kiddo.
Your answer
Fourth Child Gender
Fourth Child Status
Fourth Child Grade
Grade that they will start in the fall.
Fourth Child School
Your answer
Fourth Child School District
Your answer
Fifth Child Information
If you have fewer than five children requiring school supplies, please leave the rest of this form blank. If you have more than five children, please fill out this form again with any children that you have not already registered.
Fifth Child First Initial
Your answer
Fifth Child Last Initial
Your answer
Fifth Child Medicaid ID Number
Without this number, we will not be able to provide a backpack for your kiddo.
Your answer
Fifth Child Gender
Fifth Child Status
Fifth Child Grade
Grade that they will start in the fall.
Fifth Child School
Your answer
Fifth Child School District
Your answer
A copy of your responses will be emailed to the address you provided.
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