Bucket of Love is a 501c3 nonprofit. We are not a religious group, however, some material, music, and/or dances, may include spiritual influence.
Child(ren)'s Name and Age
Parent(s) Full Name
Emergency Contact Name & Phone (List 2)
List Child(ren)'s Challenges (Educational, Social, and/or Personal)
Please list child(ren)'s name, allergies/health conditions, current medication, primary care doctor's name and phone.