Appearance Request

Appearance Request

For Stewie the Duck
Thank you for your interest in scheduling Stewie the Duck to visit your organzation. You can learn more about our loveable water safety mascot by CLICKING HERE.

Please complete the form below to provide the details for your event. We will review your request and send you a confirmation by email within five business days.

If you have any questions, please reach out at (239) 624-4033 or safehealthychildren@nchmd.org.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organization
Presentation Type

Other
Audience Age (select all that apply)
Estimated Number of Participants
Requested Event Date (if you have multiple dates, please use the other details box below)

MonthDayYear
Date
Start Time and End Time

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Select Your Preferred Date and Time
Other Details
Event Flyer (if available)

Cancelof
Are you the contact for the date of the event?
Event Contact

First NameLast Name
Event Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address of Event

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: