Return to DPTV PBS Homepage

DPTV TV Kids Club

Thank you for registering with DPTV TV Kids Club. We are happy to have you onboard...

Birthday information must be received at least two weeks prior to the week of the birthday.

Parent or Guardian's Information

First name *

Last name *

Country *

Street Address *

Street Address 2

City *

State *

Zip/Postal Code *

E-mail address *

Name of 1st child *

DOB of 1st child *

Month

Day

Year

Gender of 1st child *

Boy

Girl

Name of 2nd child

DOB of 2nd child

Month

Day

Year

Gender of 2nd child

Boy

Girl

None of the above

Name of 3rd child

DOB of 3rd child

Month

Day

Year

Gender of 3rd child

Boy

Girl

None of the above

Name of 4th child

Gender of 4th child

Boy

Girl

None of the above

DOB of 4th child

Month

Day

Year

Name of 5th child

Gender of 5th child

Boy

Girl

None of the above

DOB of 5th child

Month

Day

Year

Name of 6th child

Gender of 6th child

Boy

Girl

None of the above

DOB of 6th child

Month

Day

Year

Additional Children

Your gift is very much appreciated and may be tax deductible pursuant to IRC §170(c). A copy of our latest financial report may be obtained at dptv.org.