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4. Congratulations! We are excited to celebrate the birth of your baby during the 250th anniversary year of the signing of the Declaration of Independence. 

   As a  semi quincentennial baby, Mayor Hall will bring  a Bluffdale Commemorative Coin as a keepsake of this memorial year. 

   Please note, the baby must live in Bluffdale to receive the special gift. 

6. Parent's Name*
7. Baby's Birthdate*
9. Email Address*
10. Phone Number*
11. Preferred Contact Method*
    -- Select One --EmailPhone Number
13. Address*
15. City
16. State
17. Zip Code
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19. 1. Receive an email copy of this form.
20. Email address

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21. Submit

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