RISE - UP!

Kids News	Register For the Program	About The Program
About The Kids You Are Helping	Send Us Your Stories And Photos!	Featured Kids
Fundraising Ideas	Educational Resources	Poster Contest
Awards & Prizes	Send In Your Donation

Fields marked with a "*" are mandatory.

CHILD'S PROFILE
First Name: *		Last Name: *
Birth: * / /	Age: *	Grade: *	* Male Female

CHILD'S CONTACT
Address: *
City/Town: *	Prov: *	Postal Code: *
Tel: *		Email:
I wish to receive Kids Helping Kids E-Newsletters
Please note: you need to provide us with your full name and address in order for IDRF to mail you your Kids Helping Kids fundraising kit. Prize winners will be contacted by phone.

CHILD'S SCHOOL INFORMATION
School Name:
City/Town located in :	School Tel :
Teachers Name:

FUNDRAISING GOAL: *
How do you plan on fundraising? *

OTHER
I am under 16 years of age
	I have parental permission to participate in the Kids Helping Kids program.
	Please enter Parental Information: First Name: Last Name: Tel:

I hereby agree to fulfill my fundraising efforts honestly and not to misuse IDRF's name and program in anyway. I will not participate in any fundraising efforts deemed unsafe and I will first get parental permission before organizing any fundraising activity.