Helping Hands 2026 - Appointment 10:30am

August 8, 2026 | Please fill out this form and click submit.

YOUR APPOINTMENT TIME: 10:30AM

On August 8, come to GraceLife during your scheduled time, and we will have your bag with goodies ready for pick-up at our Helping Hands experience.

We are located at 1640 Peppers Ferry Road, Christiansburg, Virginia.

All information will be confidential.

Participant Form

Participant Name

This address will receive a confirmation email

Phone

Address

Household Information

Please carefully read and fill out the following form. We need to know the exact number of adults and children (specific ages) residing in the household so we can best serve your specific needs.

Names of everyone in your household.

Number of Adults Residing in Household (Including Yourself)

Please select one option.

1 2 3 4 5+

Ages of Children in Household (Check all that apply.)

Please select all that apply.

None Under One Year 1 Year Old 2 Year Old 3 Year Old 4 Year Old 5 Year Old 6 Year Old 7 Year Old 8 Year Old 9 Year Old 10 Year Old 11 Year Old 12 Year Old 13 Year Old 14 Year Old 15 Year Old 16 Year Old 17 Year Old

Please let us know if you have multiple children the same age.

Do you have children under the age of 3 years old that need diapers?

Please select all that apply.

Yes No

If yes, what size diapers?

Please select one option.

Newborn Diapers Size 1 Size 2 Size 3 Size 4 Size 5 Size 6 Pull-ups (Girl) 2T-3T Pull-ups (Girl) 3T-4T Pull-ups (Girl) 4T-5T Pull-ups (Girl) 5T-6T Pull-ups (Boy) 2T-3T Pull-ups (Boy) 3T-4T Pull-ups (Boy) 4T-5T Pull-ups (Boy) 5T-6T

Oil Change

Do you need an oil change?

Please select one option.

Yes No

Please let us know the make, model, and year of the vehicle needing the oil change. If you do not need an oil change please type "N/A" in the make, model, and year boxes.

Make

Model

Year

Haircuts

Do you need a haircut certificate?

Please select one option.

No Yes

Please specify how many haircut certificates are needed. *We will do our best to accommodate the # requested. If you selected "No" above type "N/A" in this box.

Additional Comments

Description

August 8, 2026

Please fill out this form and click submit.

Helping Hands 2026 - Appointment 10:30am

Description

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