Kids Free Soiree Application Form

FREE Mini TiPi Sleepover Soiree Give Away

To ensure that all approved applicants are served, a government issued ID, copy of children's birth certificate are required. Child must be registered and required documents must be sent into 30days prior to their birthday. All forms must be uploaded through this secured link. PLEASE DO NOT EMAIL NOR MAIL DOCUMENTS.
Referring Applicants Name

PrefixFirst NameLast Name
Birthday Child's Name

First NameLast Name
Parent/Legal Guardians Full Name

First NameLast Name
Child's Birthdate

MonthDayYear
Referring Applicants Phone Number
Format: (000) 000-0000.
Applicants E-mail Address
example@example.com
Current Photo of Child

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Child's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Child(ren) Info (Twin/Triplets)
- Income Eligibility Criteria (To be eligible for The Mini Sleepover Soiree Give-Away Program, you must complete the following)
- Select which of the following you receive:
- Program Case or ID#
- If you receive Social Security Disability or SSI, attach copy or upload a photo of your 2022 Award Letter.
  
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- Do you currently reside, or have you resided in Baltimore City within the past year?
  
  Other
- *Please Read Carefully TiPi Tent Soirees is proud to serve as a GIFT agent to the Baltimore City Communities. Each application is submitted as a request and therefore not guaranteed. All application decisions are granted at the sole discretion of TiPi Tent Soirees and its partners, officers, and supporters. Please submit all required documents before the specified date/dates so that your request will be processed in an efficient timeframe for consideration. Please fill out all required information so there is no delay is submitting your referrals application. To ensure that your referrals application is considered, a government issued ID is required for legal guardian. *PLEASE NOTE: THERE WILL BE ONE CHILD CHOSEN A MONTH FOR THE FREE MINI SLEEPOVER SOIREE. The Free Mini Sleepover Soiree is for children 5yrs - 16yrs. Family with homes that do not meet our required space will be given our alternative location as an option. Parent/legal guardian must agree and complete location rules with in 7days of being notified of award. If you have any questions, please leave it in the box below.
- Comments or Questions:
- Electronic Disclosure and Signature Agreement I know that any information given to TiPi Tent Soirees will be protected and kept confidential. I know that the information on this application is needed to determine eligibility for FREE Mini Soiree Give-Away Program and/or my Income Eligibility Criteria or residential information will be checked against electronic databases at either the INCEDO System or Baltimore City Health Dept., or the Social Security Administration, or Baltimore City Public Schools. By entering your name, on the signature line, you are signing this Application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this Application and is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You further agree that your electronic signature grants TiPi Tent Free Mini Sleepover Give-Away Program the permission to confirm, where applicable, referred child's income eligibility criteria, and enrollment in Baltimore City Public Schools, and or the residential information entered on this application.
- Electronic Signature
  First and Last Name
- DateTime
- Signature
- Should be Empty:

FREE Mini TiPi Sleepover Soiree Give Away