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Enriching Newborn Infants by Giving Mothers Assistance Group 1 Christina Sbong Jessica Santibanez Quyen Tran Emilie Selwyn Rimsha Khan Cassandra Williams

Sponsored by Kimberly-Clark






INTRODUCTION Babies are amazing. If the opportunity ever comes up, you should hold a baby. When you hold a baby, it makes you notice just how tiny they are. Everything is so little, from their tiny nose to their tiny, little fists to their squirmy, little feet. In your arms, you think you might crush them because theyre so small. Babies are soft and light, but they have this way of just dropping the weight of the world on your shoulders. Babies bring out an instinctual need to protect them, and there is a lot to protect them from in this world. When you hold a baby, it really makes you understand why mothers and fathers go out of their way to provide for these tiny, little beings. Unfortunately, for parents, babies are expensive. No matter how hard moms and dads work, it may not be enough. People get sick. They lose jobs. They have to take jobs that dont pay well. Sometimes, life leaves a child with a single parent. A single mom can work a full-time, minimum wage job and still be living below the poverty line. Yes, she could pick up a second job, but dont babies need their mothers at some point in their lives? Life happens, and a lot of things in life are out of our control. Whatever the reason, there are parents and soon-to-be parents who need help. Without it, babies are the ones who ultimately suffer. Babies deserve a chance at a great start in life, but not every one of them gets one. Kimberly-Clark wants to change this. As the maker of the well-known baby brand, Huggies, our Baby Boosters program aims to leverage one of our most successful divisions into one that empowers its community at the most basic yet essential ways. With your help in starting this program, we can give these low-income families in the Dallas-Ft. Worth area a fighting chance by providing them with much needed baby supplies during a critical point in their lives and their babies lives. We would love for you, the Dallas Chamber of Commerce, to be a part of this new movement towards community care from the ground up. You can trust and rely on our partnership and dedication to this cause as we have already helped thousands of families and children (Kimberly-Clark, Programs and Partnerships, 2013). In 2011, Kimberly-Clark contributed $32.1 million in cash and product donations to charitable causes and programs such as Boys & Girls Clubs of America, MedShare International, and the United Way (Kimberly-Clark, Strengthening, 2013). Our employees and their spouses have volunteered more than 84,000 hours of their time to causes they value (Kimberly-Clark, Strengthening, 2013). Inside and out, Kimberly-Clark puts its core values of authenticity, accountability, innovation, and care into everything it does (Kimberly-Clark, Values, 2013). Baby Boosters will help sons, daughters, fathers and mothers. Your support matters. When you hold a baby, you know you are holding something important. By giving babies the essential items to start life, you can feel confident that you are investing in something that will have a great and powerful effect on hundreds if not thousands of lives for several years to come.

BACKGROUND Child poverty is a global issue. We know that its a problem in the United States, but sometimes its easier to believe that poverty only affects children in third world countries as you would see in those late night infomercials. However, the reality is that babies are born and raised in poverty right here in the United States, and its especially true for the estimated 4.4 million Texans who live below the poverty line (Associated Press, 2012). Granted, there are certainly other assistance programs, but caring for an infant until their 18th birthday can add up to an average cost of $226,920 per child (Dickler, 2011). The cost of disposable diapers alone average nearly $3,000 for just the first two years of a childs life (Crowe, 2011). With the average pay only increasing three percent per year in the last three years, low-income families have a harder and harder time keeping up with the cost of raising a child (Kavoussi, 2012). As you can see in Table 1, the U.S. Census Bureau has poverty levels adjusted by size of the family and the number of children. Based on this chart, you can see the approximate annual income of what a single or two parent household would need to have to be considered in poverty. For example, two parents with one child would be considered below the poverty threshold if they make less than $18,480 per year.

Table 1 Size of family unit

Related children under 18 years old None One Two Three Four

One person (unrelated individual) Under 65 years................. 65 years and over............ Two people......................... Householder under 65 years Householder 65 years and over

11,945 11,011

State Annual Income

15,374 13,878

15,825 15,765

Three people.................... 17,959 18,480 18,498 Four people...................... 23,681 24,069 23,283 23,364 Five people....................... 28,558 28,974 28,087 27,400 26,981 Six people......................... 32,847 32,978 32,298 31,647 30,678 Seven people.................... 37,795 38,031 37,217 36,651 35,594 Eight people...................... 42,271 42,644 41,876 41,204 40,249 Nine people or more......... 50,849 51,095 50,416 49,845 48,908 Note. From Weighted Average Poverty Thresholds, 2012, United States Census Bureau.

Also, keep in mind that in Dallas there are over 500,000 households that have children under the

age of 18 (U.S. Census Bureau, 2010). The rate of poverty for children in Dallas County is 28.3% (Pearson, 2012). That is certainly a lot of children who are living in very poor circumstances and great need. Additionally, you can below see in Figure 1 that children in Dallas County are not only poorer than most in Texas counties but also in counties on a nationwide level. The countys poverty rate is one that rivals those in New York and is one that is higher than the child poverty rate in Los Angeles. This is rather significant when you put into consideration that both areas have a higher cost-of-living than Texas (Pearson, 2012).

Figure 1. Line chart shows the rate of child poverty in various Texas counties versus the states and nations poverty rate among children. From Dallas Kids Still Abnormally Poor, Census Shows, 2012, D Magazine.

To further clarify, this cause is not just about children living in a less than favorable condition. It is about children who are born into poverty and who are immediately face a higher risk of physical developmental issues and a higher risk of mortality than children who are born into better financial circumstances (Medina, 2011). Infants are also more likely to suffer from malnutrition and absence of parental figures, which can vastly affect brain development within the first twelve months of their lives (Medina, 2011). Time spent between parent and child cant be emphasized enough due to their long lasting effects on emotional well-being. According to Jensen (2009), a newborns mental health faces a critical development point during the first 624 months of infants' lives and helps them develop a wider range of healthy emotions, including gratitude, forgiveness, and empathy. By providing baby supplies, low-income parents may have the option to choose whether they need to be working extra works or picking up a second job.

Baby Boosters goal is to give newly born infants a fighting chance that they wouldnt otherwise have. By concentrating on the early ages of life, the program can make the most impact on these families by supplying parents with baby supplies, especially items that cant be obtained through government assistance. This gives parents an opportunity to save or use the money towards other essential items or bills. Furthermore, they can also receive financial or job search advice at Kimberly-Clarks other partner, the United Way. Although we cant bring people out of poverty, we can lend a helping hand. The Dallas-Ft. Worth area has a big problem that cant be ignored, and Baby Boosters is a great way of dealing with this issue head on.


THE PROPOSAL: The Program Overview For our first year, the Baby Boosters program will help approximately 100 low-income families by providing a years worth of essential supplies for newborn babies. The low-income families will be eligible for the program based on the eligibility standards set by USDAs Women, Infants and Children program Applicants must be (Texas Department of State Health Services, 2013): 1. 2. 3. 4. Pregnant women; Women who are breastfeeding a baby under 1 year of age; Women who have had a baby in the past six months; Parents, step-parents, guardians, and foster parents of infants and children under the age of 5 can apply for their children;

In addition, they must: 1. Meet income guidelines (TDSHS, 2013). 2. Live in the Dallas-Ft. Worth Metroplex 3. Show other just cause (which can be substantiated) for receiving the supplies However, all candidate applications will be reviewed by a board of staff members who will verify that the families have produced valid documents establishing their need. The programs committee will rank each family by amount of need, and they will weigh it against special or unique circumstances because we know numbers on a bank statement or pay check dont always tell the whole story. To truly understand the level of need, we need to understand who the families are on a personal level. Once the families have been chosen, Kimberly-Clark will donate a years worth of diaper supplies for 50 families. Those families will also receive an additional supply of care items at a value of $800 per family for the year. The other 50 families will receive approximately $250 value of baby supplies for the year. All families will also receive donated supplies received from the collection leading up to the fundraising event (ENIGMA: Enriching Newborn Infants by Giving Mothers Assistance), so the value and amount of baby goods has the potential to grow much larger than our original estimate. Money raised from the fundraiser event will directly go to purchasing supplies and saving a certain amount in reserves. Depending on each familys needs, these items may include but are not limited to the following (Baby Center, 2012): Bottles, bottle brushes, pacifiers, burp cloths Diaper bag, diapers and wipes Bathing/Grooming including baby wash, lotion, ointment, baby nail clippers, etc. Onesies, socks Baby monitor Baby carrier Crib Highchair, baby spoons; and toys.


In order to target the right people, paper application forms will be strategically place in locations such as low-income based hospitals (e.g. Parkland Hospital), Texas Workforce Commission offices, and other government assistance offices. (See Appendix A.) We will also have an online application form, which families will be able to find on our ENIGMA website. Advertisements for Baby Boosters will be placed on the DART bus and rail system. There will also be flyers in children retail stores like Toys R Us so that people who know families who need assistance are also informed of this advantageous program. With Kimberly-Clarks volunteering network, the program will be able to find skilled employees with the abilities to negotiate and purchase the best possible products for the families. The procured supplies will then be packaged together for each of the families and delivered in person to each family on a quarterly basis. The company encourages volunteer work and has had a successful history in employees giving much of their time to help the community so rest assured that these families will get what they need. As the ENIGMA fundraiser grows every year, Kimberly-Clark will continue to donate until the program is completely self-sustaining in three to five years. In ten years, nearly 1,000 families can have the right start to raising families with your one time contribution.


ENIGMA: The Fundraising Event The ENIGMA event is an annual fundraiser to help financially support and provide baby supplies for the Baby Boosters program. As previously stated, it will gradually become a selfsustaining fundraising event. For its first year, the event needs an investment of $80,000 and a well-designed facility to execute the first annual mystery fundraiser. Kimberly-Clark has already pledged $50,000 towards the fundraisers budget. As for your help, in addition to your financial assistance, we would also like to utilize a convention center that facilitates the events needs for one day a year. With Kimberly-Clark donating diapers and baby wipes, the event will only need to raise $55,000 to cover all the necessary baby supplies and miscellaneous expenditures for the first year of the program. Our fundraising target is to actually raise $100,000 for the Baby Boosters program. The rest will go into reserves to help fund the event for the second year, which is why we only need a one-time initial investment from you. Your contribution would go a long way in this fundraiser. People wouldnt just be donating money and supplies. They would be more actively involved and engaged. At the heart of ENIGMA, the fundraiser is a mystery event where participants enter in to solve a mysterious crime by solving an allotment of clues in order to decipher a larger puzzle. When registering online, each team must sign up as a group and designate a team captain who will be sending and receiving the clues via text message. The following is a list of basic information prospective players may find on the website:
The Basics of ENIGMA

$20 entry fee per person Limited capacity of 5,000 players 3 Elimination Rounds (Game lasts 3 to 4 hours) Open to all ages (Parent or guardian must be present for minors)

Grand Prizes: Solve the mystery first! 1st Place - $1,000 2nd Place - $750 Visa gift card 3rd Place - $500 Visa gift Misc. contests: gift cards, XBOX, etc Figure 2. Basic information for the ENIGMA mystery game.

On the day of the event, teams will sign in at the registration desk, and each person will receive a bag of swag items, a map with seemingly random symbols placed in certain locations for the game, and game rules. The first few clues will be relatively easy; but as the game progresses, the clues will become harder. Not all teams will receive the same clue. With so many participants, we want teams to be

equally disbursed throughout the convention center. Therefore, a certain numbers of teams will be sent down a particular trail of clues which will not intersect with another grouping of teams at any point during the round. Here is how the game works: 1. At the start of the game, the participants will watch a video where the fictional City Commissioner will introduce a short story, the basic facts of the case, and the rules of the game. 2. When the video ends, the designated captain of each team will receive the first clue. When each team solves a clue, they text back the answer. 3. If it is correct, then they will receive the location of their next clue where they will find someone dressed up in costume as part of the story. 4. The costumed person will impart another piece of the ongoing storyline and hand over the next clue. Due to large number of participants, the characters will tell the story in a certain timed interval. a. If a team arrives within the timed interval, then they are allowed into the room to hear the story and receive the clue. b. If not, they will have to wait outside the room until the next timed interval begins. Additionally, there will be costumed people used to sidetrack players. If the teams end up with the wrong character, then they will be given a strike. After three strikes, the team will be eliminated from the competition. Teams may have one free pass from a strike if the team comes in with a collection of over $100 in donations during the sign-in process on the day of the event. Each round will be timed. Teams who dont finish solving all the clues by the end of each round will be eliminated. After the first round, one-third of all teams still in play will be eliminated, and then another one-third will be eliminated at the end of the second round. Finally, the third and last round will determine the winner. If more teams than the set limit for each round solve all the clues per round, then the qualifying teams will be chosen based on their speed in submitting their answers. Teams will be allowed to use electronic devices to access the internet for help solving the clues. However, volunteers will be walking around to make sure there isnt cheating within or among the teams. There will be a panel of judges to decide whether a team is disqualified.

Judging Panel Game Master Staff Writer #1 Staff Writer #1 Puzzle Creator #1 Puzzle Creator #2 Legal Dept. Head

Figure 3. Organizational chart shows who will be on the judging panel for the ENIGMA event.


Also, if for any reason, teams have technical difficulties, they may locate a volunteer to help them submit their answer and receive their next clue. Once the players have solved all three rounds of clues, they must figure out that the answer to the final puzzle pertains to an icon on the given map. (See Appendix B for puzzle examples.) At this location, the team will go through all the puzzle answers keeping in line with the mystery story with the judges. Then, with the judges approval, the first team solve the mystery will be deemed the winner. There may also be prize giveaways for teams who solve clues in the quickest time during each round and for other miscellaneous mini contests within the game. Once the winners have been determined, there will be an award ceremony that will complete the mystery story, and there will an announcement of how much money was raised.

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STAFFING FOR VOLUNTEERS In order to succeed, Baby Boosters and the ENIGMA event will need many volunteers. The program and fundraising event will share a staff of volunteers who make up the logistics, marketing, legal, and accounting teams. (See Appendix C for the organizational chart.) Fortunately, in our Irving office alone, we have approximately 1,000 employees who are willing and able to provide assistance. Additionally, in an effort to encourage volunteer work among its employees, Kimberly-Clark takes into consideration during their annual performance review how much an employee volunteers for companys projects. The company also throws a party for the department with the most volunteer hours and recognizes those employees during the annual company party. As a family company, management also encourages employees family members to volunteer as well. Here are the essential roles and responsibilities for our central team: 1. Project Manager (s) a. Oversees Baby Boosters and the ENIGMA event. b. Manages the logistics and volunteer departments and creates a schedule to do a test run/setup day before the event. c. Necessary Experience/Skills: Needs event planning background, nonprofit experience, and/or experience in projects involving budgets over $100,000. 2. Executive Assistant (s) a. Arranges meetings so that all committee can meet and be on the same page. b. Writes up progress report so that everyone is kept up to date. c. Necessary Experience/Skills: Has organizational and communication skills. 3. Logistics department a. Works with Kimberly-Clarks warehousing management to obtain storage and set up space for stockpiling and packaging the baby supplies. b. Helps the volunteer coordinator and game master successfully execute their plans within the allotted budget and with legal considerations. c. Works with the Baby Boosters transportation committee to find an effective and efficient method of delivering the baby supplies to each family. d. Necessary Experience/Skills: Has interdepartmental experience and skills in scheduling/logistics. 4. Marketing Department a. Informs public of the Baby Boosters program and ENIGMA fundraising event. i. Stirs up interest in the fundraising event. b. Creates and distributes flyers and other misc. advertisements. (See Appendix D.) c. Necessary Experience/Skills: Understands various advertising routes and tactics. 5. Legal Department a. Ensures the games are played fairly. b. Keeps program and fundraising event compliant with any state or city laws. c. Aids the project manager in obtaining the necessary permits. d. Necessary Experience/Skills: Comprehends nonprofit requirements (i.e. legal compliance), permits, and liability issues. (See Appendix E.)
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6. Treasurer/Accounting Department a. Keeps up with the organizations funding. b. Ensures the spending is appropriate and well within the budget. c. Manages and reconciles the funds with the appropriate and sufficient documents. d. Necessary Experience/Skills: Has education in accounting and budgeting BABY BOOSTERS: The Staff and Execution Baby Boosters program itself will need a review board and a volunteer coordinator. The review board will ensure the right families in need are chosen by the established criteria and use professional judgment on unique circumstances. The volunteer committee will manage all volunteer information and synchronization between the procurement, package & delivery, and transportation departments. Once the funds have been secured and the families have been chosen, the procurement team will acquire the needed baby supplies. Members will work in conjunction with the logistics team to make sure the supplies are stored in the secure and proper facility. Also, the volunteer coordinator will assign volunteers to sort, package, and deliver the goods. Additionally, the transportation team will acquire (if necessary) any needed forms of transportation in order to deliver the baby supplies to the designated families. Its members will likewise work with the logistics team to orchestrate an efficient and effective manner in which volunteers will pick up and deliver baby supplies from Kimberly-Clarks storage facilities to the disadvantaged families. THE ENIGMA EVENT: The Staff and Execution The ENIGMA fundraising event needs one year of preparation. The project managers first order of business is to find the volunteer and game master coordinators. Each coordinator will be in charge of finding team members from within Kimberly-Clarks Irving office. With the project manager overseeing the program and event, there will be a convention center liaison to iron out the details with the convention centers event services representative. The food and beverage committee would work to make sure there are vendors for the concession stands or coordinate with the convention center with its own food service. Our goal is to also find food and beverage sponsors who could provide free meals for the volunteers. Once a theme is set, the game master and staff writers will need work with the marketing department and webmaster. The staff writers will work out the plot for the overall mystery and script for each of the costumed, clue-giving characters. They will also work the puzzle makers to make sure each clue ties into the story. Throughout the story and puzzle creation, there will be an approval process to make sure the content is appropriate and in line with the programs mission. The game master will then make sure the maps and physical clues are printed and shipped on time. The game troubleshooters will actually test out the game to make sure the text messaging services operates as stated, and they will be there to work out issues on the event day. Prior to the event, the troubleshooter also will have a backup plan in place should the system crash for any reason.
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The volunteer coordinator will need to round up approximately 250 event volunteers and schedule information sessions on their responsibilities and customer service. This includes the costume supervisor who is responsible for renting the right costume and sizes for the volunteer actors and making sure the rentals go back to rental shop intact and on time. The A/V media team will help create the videos and set up the videos to work seamlessly into the mystery event. As stated earlier, there will be volunteers roaming the convention center to assist with any problems. Additionally, they will help decorate the center before the day of the event. Only one webmaster will be in charge of registration, but there will be one group of volunteers to confirm team and player arrivals and another group to help with any issues with registration. The registration team will also be putting individuals without teams into a newly formed group.

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BABY BOOSTERS BUDGET/FORECAST Program: Baby Boosters Ultimate Goal Number of Families Helped (Top 50) Value of Baby/Kid Supplies per Family # of months per year Kimberly-Clark diaper/wipes donation Needed Funding for top 50 families
50 Additional Families Helped (at value of $250 -- those who don't quite fit the requirement)

$ $ $ $ $ $ $ $ $ $

50 (150) per month (7,500) per month 12 (90,000) per year 50,000 (40,000) (12,500) (52,500) (1,000) (1,500) (55,000)

Cost of Program to Provide for all 100 families Marketing for Program (flyers, etc.) Discretionary Costs Total Expenses for Baby Boosters CONTRIBUTIONS FOR ENIGMA 2014 Kimberly-Clark Contribution Dallas Chamber of Commerce Total $ for the ENIGMA event FUNDRAISER TARGET Number of Participants Entry Fee $ for 2014 Program and Reserves for 2015 Total Expenses for Baby Boosters Reserves for the 2nd Annual ENIGMA event

$ $ $

50,000 30,000 80,000

$ $ $ $

5000 20 100,000 * 55,000 155,000

* Does not include additional funds raised from extra pass option or outside donations (e.g. if approx. 25% of all teams opt in, another $30,000 could be raised)

CONTRIBUTIONS FOR THE ENIGMA EVENT 2015 Reserves from 1st annual event $ Kimberly-Clark Contribution $ Total $ for the ENIGMA event $

45,000 35,000 80,000

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ENIGMA BUDGET KC Contribution Dallas Chamber of Commerce Total Event Expenses Excess (deficit of) funds

$50,000.00 $30,000.00 ($78,012.99) $ 1,987.01

Building Expenses Building Rental (Value = $30,000) Misc. Building Fees Power Tech. Media Use Parking (Volunteers Only - $8 at 250 ppl) Food (May use sponsors) Private Security, Janitorial Service Insurance Total Building Expenses

Donated $ $ $ $ $ $ $ 1,000.00 500.00 2,000.00 3,000.00 2,000.00 300.00 8,800.00

The Event Program Website Host - Registration $ 1,500.00 Production (Story,Clues) $ 5,000.00 Texting Program $ 1,500.00 Costumes (35 ct. @ $75) $ 2,700.00 Maps (5000 ct) $ 879.99 Grand Prize $ 1,000.00 Other Prizes (Gift Cards, XBOX, etc.) $ 4,000.00 Decorations $ 5,000.00 Banners (3) $ 900.00 Bag of Goodies/Swag (See Appendix F for goodie bag.) Customized Wristbands (5000 ct @ $.13 ea) $ 650.00 Customized Water Bottles (5000 ct @ $.79 ea) $ 3,950.00 Customized T-shirts (5400 ct @$4.86 ea) $ 26,244.00 Customized Pens (5000 Bic ct @.27 ea) $ 1,350.00 Total Program Expenses $ 54,673.99
Publicity Flyers (10,000 count) Radio (40 airplays) Local News - (Partner with local TV station) Social Networking ("Promote" on FB, Twitter, etc.) Total Publicity Expenses $ 1,999.00 $ 11,840.00 $ $ 300.00 $ 14,139.00
Miscellaneous Special Event Permit (City Police) Food Permit Total Misc. Expenses $ $ $ 200.00 200.00 400.00

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CONCLUSION Every day, newborn infants are born into poverty in the Dallas-Ft. Worth area. There are babies out there right now who dont have access to medical services when they are sick, who dont have enough food, or who dont get the needed attention and love from their parents because theyre busy working a second shift or job. Kimberly-Clark wants to give back hope and relief to parents who should be celebrating a happy addition to their lives. Baby Boosters goal is to help meet the basic needs of those children. With ENIGMA as a future self-sustaining source of income, the program has a chance to unite our community towards weakening the effects of child poverty in our city.

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AUTHORIZATION To the Dallas Chamber of Commerce: When Kimberly-Clark was first created, only $30,000 was invested into it; and now, it has turned into a multinational organization with various brands that are recognized worldwide. With this in mind, we are asking you to donate the use of a convention center once a year and $30,000 in order to get the ENIGMA mystery event up and running. Once the funds are raised, Baby Boosters can then assist thousands of mothers and fathers to get the necessary supplies for their newborn infants for years to come. Your partnership is greatly valued, and we look forward to working with you. Sincerely, The staff at Kimberly-Clark

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Works Cited Alaska Department of Health and Social Services. (2012). Family Information. Retrieved from mation.pdf Associated Press. (2012, February 5). State Has Texas-Sized Poverty Problem. CBS DFW. Retrieved from Baby Center. (2012). Checklist: baby registry must-haves. Retrieved from County of Sonoma Department of Health Services. (2011). Applying for the WIC Nutrition Program. Retrieved from Crowe, Aaron. (2011, February 8). Disposable vs. Reusable Diapers: How to Save. Daily Finance. Retrieved from Dickler, Jessica. (2011, September 21). The rising cost of raising a child. CNN Money. Retrieved from Jensen, Eric. (2009). Chapter 2 How Poverty Affects Behavior and Academic Performance. ASCD. Retrieved from Kavoussi, Bonnie. (2012, July 17). Median Pay Raise Just 3 Percent in U.S. In 2012, Study Says. Huffington Post. Retrieved from Kimberly-Clark. (2013). Programs and Partnerships. Retrieved from Kimberly-Clark. (2013). Strengthening Families. Retrieved from Kimberly-Clark. (2013). Values. Retrieved from Medina, Lily. (2011, November 21). The Effects of Poverty on Infant Development. Livestrong. Retrieved from

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Nonprofit Risk Management Center. (2013). Template Volunteer Release and Waiver of Liability Form. Retrieved from Pearson, Bradford. (2012, December 13). Dallas Kids Still Abnormally Poor, Census Shows. D Magazine. Retrieved from Texas Department of State Health Services. (2013, February 13). WIC Eligibility. Retrieved from U.S. Census Bureau. (2010). Profile of General Population and Housing Characteristics: 2010. Retrieved from view.xhtml?pid=DEC_10_DP_DPDP1 U.S. Census Bureau. (2013). Poverty thresholds by Size of Family and Number of Children: 2012. Retrieved from thresh12.xls United Way of Metropolitan Dallas. (2013). Income. Retrieved from University of Wisconsin-Madison. (2013). Institute for Research on Poverty. Retrieved from

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Dallas Texas Kimberly-Clark Application for Baby Booster Assistance

You must bring proof of current income, proof of address and your infant/child to your BB appointments Medical information must be less than 45 days old on the date of your appointment. Parent/Guardians Name: ________________________ Infant/ Childs Name: ___________________________ Infant/Childs Birth date: _________________________ Infant/ Childs Social Security number:_____- ____-___ Address: ___________________________________ __________________________________________
Phone: ____________________________________________

Do you already get Baby Boosters assistance in your household? Yes No Race: White Asian American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander Hispanic? Yes No What is the highest grade in school you completed? ________________________________________ Black or African American

Email Address: ______________________________________

Household Information: (please provide proof

of income and identification) Are you currently on BB? Have you been on BB before? Are you currently working? Is anyone else in the household working? Yes Yes Yes Yes No No No No

If yes, where? _____________________________

If yes, where? ___________________________________________ Pay per hour? ____________ Hours worked per week? _______

Are you? Married Separated Single Living with a partner/Significant other Divorced

If in the military, what branch? USMC National Guard

Air Force Coast Guard

Army Navy

Are you currently being provided services by the following? Women Infants and Children Program (WIC) Supplemental Nutrition Assistance Program (SNAP) Other? ___________________________________

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Supplies Information:
(BB will provide necessities such as diapers, bottles, pacifiers, burp cloths, baby wash, a high chair, baby spoons, baby lotion, ointment, onesies, socks, toys and etc. The following questions will pertain to specific items.)

Age of child:

1-3 months 3-12 months

1-2 years 2-3 years

3-4 years

Sock size:

Not sure

Infant/ childs weight: ________________

Infant/ childs Height: _______________

Infants and Children

Full provision of supplies will be provided unless the following is checked: Provide all supplies except for baby wash, lotion and ointment due to past history of allergic reactions. Any known allergies? Yes No

Required Health Care Provider Information

Signature/ stamp of Health Care Provider (MD, DO, PA, NP):

_______________________________ Date: _________

Providers Name (Print): ____________________________ Phone No: (________) -__________-________ Fax No: ________________________________

If yes, please list allergies _______________________

BB Use Only

Reproduced and altered based on this application:

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BB Family Name ________________ How to Apply for the Baby Boosters Program Welcome to Baby Boosters! BB is here to help you raise healthy, strong children. While on this program we will be helping your family by providing important supplies for young children such as diapers, baby lotion, baby ointment, a baby bottle, socks, and much more! When and where to come? You can find our application online. Once filling this application out a time and date will be sent to you through email informing you about the best location for your appointment and designated timings. Our application will also be located in hospitals and other government institutions. If you need any assistance in finding out where to come or how to access the application online you may call us at 1-800-456-4533. What to bring (if you have an appointment): 1. Proof of Identity: This is any official document that says who you are. For women, a picture ID is preferred. For infants and children, use a birth certificate, crib card, immunization record, Medicaid or Social Security card. If you do not have one of the above, ask BB staff to explain other forms of acceptable identification. 2. Proof of Income: If your family receives Medicaid or Food Stamps, just bring a Medicaid card or Social Security number for each family member who may be eligible for WIC. If you do not receive Medicaid or Food Stamps, please bring proof of your total gross family income for at least one full current month. Gross income means before any deductions for taxes or expenses. Some examples include pay stubs, bank statements showing automatic deposits for SSI, military LES, or books for your own business. If you live with the father of any of your children, his income must be reported. If your income varies or is seasonal, bring records for several months to show an average income. If you recently became unemployed we will use your current income, not your income when you were working. 3. Proof of Address: Bring a current utility bill, rent receipt or mail you recently received at your home. If you are homeless and cannot provide proof of address, you may still be eligible for BB. 4. Baby Medical Information Current height or length and weight are mandatory for everyone and can be done at BB. Blood test results: Blood test results are needed within 90 days of BB enrollment for all women and children, (except for infants who were under age 9 months on the date of the first BB appointment). 5. Present at Certification: All applicants must be present at the first certification. Please bring your children with you to your appointment. This institution is an equal opportunity provider.
Reproduced and altered based on this application:

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APPENDIX B Simplified Version of the ENIGMA Game Solve each clue, and then insert answers into the final puzzle for your final answer. 1. Papa Alfa Romeo India Sierra India Charlie Oscar November 2. Catwomans 16th century husband penned these choices: One gold coffin, one silver coffin, one lead coffin. Pick wisely, and win a hand. 3. The Mother of castaways and her eternal flame. 4. 119 104 101 114 101 69 103 121 112 116 115 99 101 110 116 97 117 114 108 105 101 115 Final Puzzle:

- .... .-. --- ..- --. .... / - .... . [?] -.-. .- -. .- .-.. ... / .- -. -.. / - .... . [?], --- -. .-.. -.-- / - --- / ..-. .. -. -.. / - .... . [?] .- -. -.. [?]... - .- -. -.. .. -. --. / -... .-.. --- -.-. -.- / -... -.-- / -... .-.. --- -.-. -.- ..-.- / -.-. --- -- . / ... .- ...- . / -- . .-.-.Answers to Clues: 1. NATO Phonetic Alphabet: Paris Icon = Eiffel Tower 2. Merchant of Venice 3. Statue of Liberty 4. Decode with ASCII language: Where Egypts centaur lies Sphinx Sahara Desert Final Puzzle - Use Morse code: Through the [?] canals and the [?], only to find the [?] and [?] standing block by block. Come save me. Through the Venice canals and the Sahara Desert, only to find the Eiffel Tower and Statue of Liberty standing block by block. Come save me. Final Answer: Las Vegas

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Project Manager

Baby Boosters/ENIGMA

Logistics Coordinator

Accounting Dept. Head

Marketing Dept. Head

Legal Dept. Head (Judge)

2 Staff

2 Staff

Project Manager

Baby Boosters


Review Board

Volunteer Coordinator

Convention Center liaison


Game Master (Judge)

Volunteer Coordinator


2 Staff Writers (Judges)

Game Troubleshooter


General Helpers

A/V Media

Package & Deliver

Transportation 2 Puzzle/Clue Producers (Judges) 25 Event Volunteers


Decorators/Cust omer Service

On-Site Sign In

Costume Supervisor

Registration Troubleshoot

30 Characters

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APPENDIX E Participant Release and Waiver of Liability Form

This Release and Waiver of Liability (the release) executed on this ______ day of ___________, 2014, by ____________________________ hereby releases the following Persons and Entities Released and otherwise (Name of Participant) agrees as follows: Persons and Entities Released: Kimberly-Clark and its subsidiaries, all Committee personnel and all affiliated Sponsors (the participating entities), and all others, jointly, severally, and individually. The Participant desires to provide participant services and engage in activities related to serving as a participant for Baby Boosters on out be referred to as The Program, to be operated by Kimberly-Clark. A private entity not affiliated with Kimberly-Clark, the above named participant hereby agrees as follows:


WAIVER AND RELEASE: I, the Participant, release and forever discharge and hold harmless the above listed entities from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I provide. I understand and acknowledge that this Release discharges from any liability or claim that I may have with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I am providing for the Baby Boosters Program. INSURANCE: Further I understand that none of the above participating entities assumes any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits, or insurance of any nature in the event of my injury, illness, death, or damage to my property. I expressly waive any such claim for compensation or liability on the part of the participating entities. MEDICAL TREATMENT: I hereby Release and forever discharge the participating entities from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a participant with the ENIGMA Event. ASSUMPTION OF RISKS: I understand that the services I provide to the Program may include activities that may be hazardous to me including, but no limited to involving inherently dangerous activities. As a participant, I hereby expressly assume the risk of injury or harm from these activities and Release ALL participating entities from all liability for injury, illness, death, or property damage resulting from the services I provide as a participant or occurring while I am providing participant services for the ENIGMA Event. OTHER: As a participant, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas and that this Release shall be governed by and interpreted in accordance with the laws of the State of Texas. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.





By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.

___________________________ Signature

____________ Age

________________________ Date

If participant is under the age of 18, a parent/guardian must read and sign this Release/Waiver of Liability Form

___________________________ (Signature of Guardian)

Reproduced and altered to fit with the event:

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