First Birthday

Child's name: Parents' names: Address: Siblings' names and ages:

Date of birthday:

Date of party (if different than birthday):

Grandparents' names and locations: Guests at party (optional):

Please choose a method to submit your photo:

Mailing photo

Attaching photo via this form

Not sending photo

Attach photograph in JPEG/JPG format: (File size limit is 5MB) Choose a file

Mail photo to:
West Liberty Index
214 N. Second Street
Eldridge, IA 52748

First Name: *

Last Name: *

Phone:

E-mail: (A valid e-mail is required.) *