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NewsChannel 7 Birthday Club! Register your birthday or someone you know and join the NewsChannel 7 Birthday Club! Birthday Club members will receive a signed card from NewsChannel 7 anchors and a special offer from Sam's Pizza!  Birthdays will be recognized on-air during NewsChannel 7 DayBreak. After completing the form below, please send any photo submission to birthdays@wsaw.com. Please include the name in the email so we can match this up with your entry below. 1.Contact Information First Name of Applicant* Last Name Applicant* Who Greeting is From Street Address of Applicant* City of Applicant* State of Applicant* Zip Code of Applicant* 2.Message Box: Send a message to the birthday club applicant here. 3.Child's Birthdate Month* Day* Year* JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 01020304050607080910111213141516171819202122232425262728293031 20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914191319121911191019091908 4.Birthdate of person submitting this form. (If you are under 13 years of age, your parent or legal guardian must register you for the birthday club.) Month* Day* Year* JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 01020304050607080910111213141516171819202122232425262728293031 20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914191319121911191019091908 * represents required fields Children under the age of 13 may not submit this form.

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