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CLIENT APPLICATON

This form must be completed in advance of diaper pick-up.

Eligibility: 
Montgomery, Alabama residents who are parents, guardians or caregivers for children 3 1/2 years of age or younger (42 months). Applicants must provide number of children in household.

PLEASE READ CAREFULLY

  • By submitting this application, I acknowledge and agree to the following:

  • I understand that Express-O of Love Diaper Bank distributes donated diapers based on available inventory and cannot accommodate requests for specific brands or styles. Baby wipes may also be provided when available. Availability of diapers and wipes is not guaranteed.

  • I understand that each family must sign a product liability waiver. All diapers and wipes are donated to Express-O of Love for distribution to families in need. Express-O of Love assumes no responsibility or liability for the condition, use, or performance of the products distributed.

  • I understand that all diapers and wipes received are solely for the use of the child listed on this application. They may not be sold, exchanged, or redistributed to others.

  • I understand that diaper bank services are available only to residents of Montgomery, Alabama.

  • I grant Express-O of Love permission to photograph or record me and/or my child during its programs and events and to use these photographs, videos, or likenesses for promotional, educational, fundraising, and community-outreach purposes.

One Application Per Child

Client Application
Relationship to Child
Child's Race

Please know that if you have any questions or need additional assistance, feel free to give us a call at (205) 538-0062 or email us at expressooflove@outlook.com.

Thank you for submitting your application! Please mark your calendar for upcoming diaper distribution dates.

This form no longer accepts submissions.

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