Texas Health Resources
Birthday Buddies Registration

Please complete and submit this form to receive Birthday Buddies information to send to your child's party guests.

A RED asterisk (*) denotes required fields. After completing all fields click on the Submit button.

Child's Last Name: *
Child's First Name: *
Parent First Name: *
Parent Last Name: *
Street: *
Street 2:
City: *
State/Province: *
Zip: *
Phone Number: *
Child's Birthdate:
How many guests are you inviting? *
What is the date of your party? *
Is your child currently a Birthday Buddy?
Which Texas Health NICU would you like your donations to benefit? *

Where did you hear about Birthday Buddies? *


Please enter authentication challenge characters below and click Submit button only once.

Texas Health Foundation Birthday Buddies
612 E. Lamar Blvd., Suite 300
Arlington, Texas 76011
682-236-5201 - Fax
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