Become a Co-op Kid
Fill out the form to become a Co-op Kid! Co-op Kids will receive a special membership card in the mail, and have access to special contests, treats and events.*

Every month we will pick one lucky winner to enjoy a Birthday Party Pack! We hope you become a part of our Co-op Kids Club.

*Must be age 12 and under to be a part of the Co-op Kid Club.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Parent/Guardian's Name *
Your answer
Street/Mailing Address *
Your answer
Town *
Your answer
Postal Code *
Your answer
Phone number *
Your answer
E-mail *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Parents Co-op # (optional)
Your answer
Questions and comments
Your answer
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This form was created inside of Winkler Consumer's Co-op.