Summer Bucket List Completion Form

Fill out the form below for each child (18 and under) who completed the Whitestown Summer Bucket List.

Participant Name(Required)

First Last

Participant's Age(Required)

Contact Person Name(Required)

First Last

Email

Phone

Town/City of Residence(Required)

What's the best way to reach you to claim your prize(s)?(Required)

Upload photos of the participant completing the summer bucket list items.(Required)

Drop files here or

Max. file size: 50 MB.

Do you grant the Town of Whitestown permission to use your photo(s) for publication?(Required)

Town of Whitestown Newsletter

In addition to breaking news alerts, we send a monthly e-newsletter that details all the happenings in the town.

Yes - Please subscribe me to the Newsletter

How can we help?