Form Testing Page

2024 Shop with a Hero

Application available 09/1/2024 and due by NOVEMBER 13, 2024 by 5PM, applicants will receive a phone call and a personal email between November 28th and December 1st to let them know if their child/children were chosen to participate in this event.

Thank you for applying for our “Grundy County Heroes & Helpers Shop with a Local Hero Event”. This
event is a 1-day event on Saturday, December 7, 2024, reserved for Grundy County, Illinois children between the ages of 4 through 15 years old, whose families have suffered some kind of hardship and in need of assistance this holiday season. In order for your child(ren) to participate in our event, the following are required: (Each application is reviewed and carefully considered for approval)

Shop with a Local Hero

Download and print Shop with a Hero form

Thank you for applying for our “Grundy County Heroes & Helpers Shop with a Local Hero Event”. This event is a 1-day event on Saturday, December 7, 2024, reserved for Grundy County, Illinois children between the ages of 4 through 15 years old, whose families have suffered some kind of hardship and in need of assistance this holiday season. In order for your child(ren) to participate in our event, the following are required: (Each application is reviewed and carefully considered for approval)

Consent(Required)

I agree to the following:

All applications and forms must be completed in their entirety and returned to Grundy County Heroes & Helpers Inc., P.O. Box 116, Minooka, IL 60447 by the deadline (NOVEMBER 13, 2024). Any applications received beyond the deadline and/or have missing/omitted information or forms will cause the application to be denied.
2. All applicant’s families must be experiencing loss, trauma, poverty, and/or hardships of some kind and provide a detailed account of said event to qualify for this event.
3. All participating children must be between the ages of 4 and 15 years of age and live in Grundy County, Illinois on a full-time basis or attend a school in Grundy County, Illinois.
4. All applications MUST include a working phone number that allows you to be contacted about our event and on the date of the event, cell phone numbers are best.
5. All applications must include a Hero Shopping List, Hold Harmless Release, Waiver of Liability and Hold Harmless Agreement and Media Consent form for each child listed in the application.
6. On the shopping day, a parent/legal guardian and the child(ren) must be present at all times during the event. No purchases will be made for children not in attendance. Arrive 15 minutes prior to the start of our event so your child does not miss their opportunity to participate. In the event you cannot make it, you must contact us by calling 815-200-6957. Parents/Legal Guardians are responsible for all transportation to and from this event.
7. Once you arrive at the event, please proceed to the check-in area. Your child(ren) will be paired with a local hero form the local police, fire and/or EMT departments as well as a helper. Your child’s shopping experience will be followed by lunch with Santa & Heroes where they will also receive FREE toys. You will receive a phone call by a volunteer between November 27
th and December 1st, with approval or denial for our event, at this time you will be given details of our event.
8. Each selected child’s hero will be allowed to spend a specific amount of money for your child(ren) at the event and will not be allowed to go over this set amount. All merchandise purchased during our event cannot be returned, only exchanged for a different size. A list of the purchased items will be provided to the service desk and any item purchased that is returned will be reported to our agency and your child may be ineligible to participate in future events.
9. All children selected to participate will be reviewed carefully for consideration. All applications, both liability releases, hardship and photo release forms must be received no later than November 13, 2024, by 5PM.
Any Questions please send an email to [email protected] or call 815-200-6957.

A separate application for each child should be completed and returned to the address below. DO NOT leave any spaces blank. Missing or omitted information will cause your application to be DENIED. A working telephone number must accompany this form. Eligible children are those between the ages of 4 through 15 years. On the shopping day, your child must be present in order to shop. Your child must live and attend a school in Grundy County.

Name of Responsible Parent/Guardian/Party:(Required)

First Last

**Responsible Person must be present during the entire event and able to provide transportation to and from all event locations

Relationship to Child(Required)

Parent

Guardian

Other

Address(Required)

Street Address City State ZIP Code

Email(Required)

Phone(Required)

(You must provide a valid telephone number)

Best time to call

Anytime

Total Combined Annual Household Income:(Required)

Total Number of persons in household:(Required)

Have you recently been laid off?(Required)

Yes

Have you applied for assistance from any other organization?(Required)

Yes

When were you laid off?

Which organizations have you applied for assistance from?

Has your child/children attended any of our Shop With A Local Hero events in past years?(Required)

Yes

(please note, this will not determine if your child is chosen)

Please specify the years your child has attended

Proof of residency(Required)

Max. file size: 256 MB.

Copy of bill in guardian’s name with current address

Valid Driver’s License of guardian(Required)

Max. file size: 256 MB.

Date

MM slash DD slash YYYY

Please complete for each child

Child's First Name	Child's Age	Child's Gender	Actions

There are no Children.

Maximum number of children reached.

Consent(Required)

I agree

**By completing and signing this application, you are giving your consent for your child(ren) to participate in this event, agree to abide by the rules provided for on the information page, give consent for Grundy County Heroes & Helpers Inc. to make any inquiries with other organizations regarding assistance you are receiving and understand you are responsible for providing any and all transportation for your child(ren) to and from this event

Signature(Required)

Name of signatory(Required)

First Last

Form Testing Page

Shop with a Local Hero

(815) 200-6957