1st Birthday Bash RSVP
As of Thursday night, there are only 10 spaces left!  Register quickly before we reach capacity!

Fill out this form to register your children for the 1st Birthday Bash at BounceU on November 18 from 5:30 - 7:30pm, then send in your donation for the event.  

You can donate by check, credit card or PayPal.  Once your donation has been received, we will email (or mail) your confirmation receipt for our 1st Birthday Bash within 24 hours.  This receipt will serve as your admission ticket to the fundraiser.

Make checks payable to "Piedmont Diaper Bank - NIN" and mail to:
     Piedmont Diaper Bank
     6032 Fairfield Oaks Lane
     Pfafftown, NC  27040

To donate by credit card or PayPal, go to our Donate Page and follow the instructions for online donations.
We respect your privacy.  We will never sell or share your personal information to others.

If you have any problems or questions, contact us at PiedmontDiaperBank@gmail.com or 336-422-6421.
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Name *
Name of the person making the donation
Email Address *
Street Address *
City, State, Zip *
Total Donation *
$8 per child suggested donation (parents, guardians and babies under age 1 are free)
Type of donation *
Don't forget to make your donation when your finish the registration
Names and ages of children attending *
How would you like your confirmation receipt sent to you? *
please bring receipt to the event on Nov. 18
Phone Number
so we can contact you if we have any questions about your RSVP
Do you want to receive our email newsletter?
just to keep you updated on how the diaper bank is helping the community, current diaper drives and upcoming special events...
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How did you hear about our 1st Birthday Bash fundraiser?
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