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: *
 
 
E-mail:*
 
 
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
682-236-5249
682-236-5201 - Fax
www.texashealth.org
This page is displayed via a secure connection that can be confirmed by noting the �https� prefix in the URL and, in Internet Explorer, by appearance of a Secure Sockets Layer (SSL) padlock icon in the browser status bar at lower right. Any information you exchange with this site is protected from view by other Internet users. Any e-mail addresses you enter may be used to send you a verification message, but such addresses will not be used to request personal information of any type nor will any contact details be shared with other companies. See the Texas Health Resources Privacy Statement for more details. Texas Health uses industry-standard encryption technologies when transferring and receiving payment data. If you have questions regarding this page, please contact us for more information.