Kid's Smile Box — Lyme Warrior

Accepting Applications for Kid Smile Boxes

Apply for your

little Lyme Warrior

to receive a Smile Box

of goodies.

Next round of boxes will be delivered mid to end of December 2018.

Kid's Name *

Kid's Name

First Name

Last Name

Parent's Name *

Parent's Name

First Name

Last Name

Email Address *

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tell us about your Lyme Warrior - More information on likes/dislikes and education level help us sort items appropriately. *

Age *

Gender *