Brace Painting Event Form

Event Order Form

"*" indicates required fields

How would you like to make your donation?*

Brace painting kit

Standard donation

Is the painter 18 years of age or older?*

Yes

No

Age of minor

Please ensure you are sharing your parent/guardian's contact information. Hope Walks can only gather information, communicate and send finished brace photos to adults, 18 years or older.

First Name*

Last Name*

Email*

Phone

Mailing Address

Street Address Address Line 2 City State ZIP / Postal Code

How many leathers would you like?*

Please enter a number from 1 to 100.

Suggested Donation

Price: $15.00

Total Credit Card Paid

Great! Please hand the iPad back to the Hope Walks Team.

Thank you for entering your contact information. We'll add the tracking numbers for you, but please stay with us to make sure we have what we need. Note to Staff: This is only needed for braces painted on site.

Brace Tracking Number

Do you have more tracking numbers to add?

Yes

No

Brace Tracking Number

More tracking numbers to add?

Yes

No

Brace Tracking Number

Event Form 20

Event Order Form

Great! Please hand the iPad back to the Hope Walks Team.

A treatable condition shouldn’t keep a child from walking.

Follow

Contact

Clubfoot is Treatable

Join Us

About Us

Sign up for Stories of Hope