2022-05-16T13:04:35-05:00 2021-12-31 208149084 ANASTASI MOORE & MARTIN PLLC 9 S WASHINGTON ST STE 600 SPOKANE WA 99201 990 2021-01-01 203584556 CHILDS PLAY CHIL 4255298885 9660 153RD AVE NE REDMOND WA 98052 ELAINE CHASE PRESIDENT 4255298885 2022-05-11 1 ELAINE CHASE 999009999 PAUL ANASTASI CPA P00395796 5093230272 2022-05-11 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z ELAINE CHASE 9660 153RD AVE NE REDMOND WA 98052 4171250 0 X WWW.CHILDSPLAYCHARITY.ORG X 2005 WA CHILD'S PLAY IMPROVES THE LIVES OF CHILDREN THROUGH THE POWER OF PLAY. 5 5 5 29 34721 0 4091136 3781650 0 0 134562 312600 113699 31089 4339397 4125339 2270975 3022839 0 0 535984 548872 0 0 348519 337843 516476 3144802 4088187 1194595 37152 12331499 14460372 484345 1162693 11847154 13297679 CHILD'S PLAY SEEKS TO IMPROVE THE LIVES OF CHILDREN AND TEENS IN THE IN PEDIATRIC HOSPITALS AND OTHER CHILD WELFARE FACILITIES THROUGH THE KINDNESS AND GENEROSITY OF THE GAMER COMMUNITY AND THE POWER OF PLAY. 0 0 3393324 3022839 STARTED BY THE FOUNDERS OF PENNY ARCADE, INC., MIKE KRAHULIK AND JERRY HOLKINS IN 2003 UNITING THE GAMING COMMUNITY AND HIGHLIGHTING THE GOOD IN THE INDUSTRY WHEN GAMERS GIVE BACK! FOCUSING ON HELPING IMPROVE THE PATIENT EXPERIENCE, CHILD'S PLAY WORKS CLOSELY WITH CHILD LIFE DEPARTMENTS TO UNDERSTAND THEIR TECHNOLOGY NEEDS, PROVIDE SOLUTIONS TO GAMING ROADBLOCKS AND SUPPORT THEIR HOSPITALS PROGRAM WITH IN-KIND AND CASH CONTRIBUTIONS. WE SUPPORT MORE THAN 180 HOSPITALS AND IMPACT MORE THAN 1MILLION KIDS EACH YEAR. IN RECENT YEARS, CHILD'S PLAY HAS HEAVILY FOCUSED ON GAMING AND TECHNOLOGY SPECIALISTS. THESE POSITIONS INSIDE CHILDREN'S HOSPITALS HAVE PROVEN TO ENHANCE THE PATIENTS EXPERIENCE WHILE CREATING AN ENVIRONMENT THAT IS INCLUSIVE AROUND GAMING. THESE TECHNOLOGY SPECIALISTS PROMOTE IMMERSIVE TECHNOLOGY SUCH AS AUGMENTED AND VIRTUAL REALITY TO HELP PROVIDE DISTRACTION DURING PROCEDURES. THIS CAN HELP KIDS GET HOME SOONER AND HEAL QUICKER. CHILD'S PLAY HAS FUNDED 30 OF THESE POSITIONS TO DATE THROUGH CAPACITY BUILDING GRANTS AND CONTINUES TO LOOK FOR ADDITIONAL DONOR/SPONSOR SUPPORT TO GROW THIS PROGRAM. THESE GRANTS ALLOW THE HOSPITAL TO SUPPORT THIS NEW POSITION IN 2 TO 3 YEARS. WE KNOW NOT ALL CLINICIANS AND CARETAKERS IN AND OUTSIDE THE HOSPITAL SETTING ARE GAMERS. WE WANT TO MEET PEOPLE WHERE THEY ARE AT AND SHOW THEM THE BENEFITS OF GAMING AND POWER OF PLAY. THAT'S WHY CHILD'S PLAY CREATED THE THERAPEUTIC VIDEO GAME GUIDE A TOOL TO RECOMMEND VIDEO GAMES FOR CHILDREN BASED ON THEIR SYMPTOMS. THE GAMES AE CURATED BY RESEARCHERS AT NPD GROUP, INC., A MARKET-LEADING VIDEO GAME RESEARCH FIRM, IN COLLABORATION WITH MENTAL HEALTH RESEARCHERS AT UCSD. THIS GUIDE WAS DESIGNED AS A QUICK REFERENCE TO HELP CARETAKERS QUICKLY SELECT GAMES FOR THEIR PATIENTS. 3393324 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 1 4 0 1 5 1 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 X 5 5 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WA X TRAVIS ERIKSEN 4255298885 9660 153RD AVE NE REDMOND WA 98052 ELAINE CHASE PRESIDENT 2.00 X X 0 0 0 MIKE KRAHULIK VICE PRESIDENT 2.00 X X 0 0 0 ASHER MARKS SECRETARY 2.00 X X 0 0 0 MIKE HAYES TREASURER 3.00 X X 0 0 0 MATEO MESSINA BOARD MEMBER 2.00 X 0 0 0 TRAVIS ERIKSEN EXECUTIVE DIRECTOR 40.00 X 123513 0 5963 KIRSTEN CARLILE DIRECTOR OF PHILANTHROPY & PARTNER EXPERIENCES 40.00 X 101563 0 20198 225076 0 26161 2 0 0 0 0 135375 3646275 361582 3781650 311157 311157 1443 0 1443 1443 1443 18698 135375 22330 -3632 -3632 4700 0 4700 4700 53602 23581 30021 30021 4125339 0 34721 308968 2784892 2784892 237947 237947 129476 32369 64738 32369 326033 117137 92512 116384 10661 4549 1441 4671 47483 17692 12287 17504 35219 12016 11248 11955 3950 950 3000 21961 21961 90740 90740 11900 11900 5783 3427 2356 230303 97889 11762 120652 67024 21057 21791 24176 25752 23912 978 862 260 260 10214 10214 SUPPLIES 36151 27435 8716 WAREHOUSING EXPENSE 7488 7488 TAXES, LICENSES & PERMI 3692 152 3412 128 ONLINE RETAIL FEES 1258 1258 4088187 3393324 346344 348519 335666 849511 3185004 1235680 69 48953 128960 40497 2231 127085 182387 56118 49666 11668 6980 4947 4688 5220397 5734552 3267283 6306237 5970 5970 12331499 14460372 77925 80492 251434 925416 150000 153500 4986 3285 484345 1162693 X 11743566 13270308 103588 27371 11847154 13297679 12331499 14460372 37152 1413373 0 X 0 1 X 1 0 X 3105931 147607 3758197 4091136 3781650 14884521 3105931 147607 3758197 4091136 3781650 14884521 3373987 11510534 169761 79038 304131 182670 311157 1046757 15931278 0.72250 0.62250 X SCHEDULE A, PART II, COLUMN B: COLUMN B REFLECTS A CHANGE IN ACCOUNTING PERIOD AND ONLY INCLUDES 3 MONTHS' WORTH OF DATA. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5055 367 4688 6613 6613 0 4688 REAL ESTATE INVESTMENT TRUSTS 1540477 F FUND OF FUNDS 812502 F MASTER FEEDER FUND 2483214 F MASTER FUND 1470044 F 6306237 5501283 1413373 7400 1420773 4080510 90740 -45911 44829 4125339 4050758 7400 45911 53311 3997447 90740 90740 4088187 PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -22,330. COST OF GOODS SOLD -23,581. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 22,330. COST OF GOODS SOLD 23,581. 1 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES GRANTS TO LOCAL RECIPIENTS/CHILD WELFARE ORGANIZATIONS 37233 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES GRANTS TO LOCAL RECIPIENTS/CHILD WELFARE ORGANIZATIONS 150100 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES GRANTS TO LOCAL RECIPIENTS/CHILD WELFARE ORGANIZATIONS 1000 NORTH AMERICA 0 0 PROGRAM SERVICES GRANTS TO LOCAL RECIPIENTS/CHILD WELFARE ORGANIZATIONS 48614 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES GRANTS TO LOCAL RECIPIENTS/CHILD WELFARE ORGANIZATIONS 1000 0 0 0 0 0 0 237947 0 237947 EUROPE (INCLUDING ICELAND & GREENLAND) GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 117100 EFT 0 NORTH AMERICA GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 18864 EFT 0 EAST ASIA AND THE PACIFIC GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 11000 EFT 0 NORTH AMERICA GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 7750 EFT 0 EUROPE (INCLUDING ICELAND & GREENLAND) GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 7000 EFT 0 EUROPE (INCLUDING ICELAND & GREENLAND) GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 7000 EFT 0 EAST ASIA AND THE PACIFIC GAMING AND TECHNOLOGY EQUIPMENT AND PROGRAMS 7000 EFT 0 7 0 0 0 0 0 0 0 PART I, LINE 2: CHILD'S PLAY REQUESTS A REPORT FROM THE ORGANIZATION DETAILING HOW THEY USED THE FUNDS. PART I, LINE 3: ALL AMOUNTS REPORTED ON PART I, LINE 3, COLUMN (F), ARE EXPENDITURES, WHICH ARE REPORTED ON THE ACCRUAL BASIS OF ACCOUNTING AND INCLUDE GRANTS PAYABLE. GRANTS PAYABLE CONSIST OF UNCONDITIONAL FUNDING COMMITMENTS MADE TO OTHER ORGANIZATIONS. UNCONDITIONAL GRANT PAYMENTS ARE ALL DUE IN THE NEXT TWO YEARS. GRANTS AUTHORIZED BY CHILD'S PLAY BUT UNPAID AT YEAR END ARE REPORTED AS LIABILITIES. PART III ACCOUNTING METHOD: PART II, LINE 1: GRANTS ARE REPORTED ON THE ACCRUAL BASIS OF ACCOUNTING AND INCLUDE GRANTS PAYABLE. GRANTS PAYABLE CONSIST OF UNCONDITIONAL FUNDING COMMITMENTS MADE TO OTHER ORGANIZATIONS. UNCONDITIONAL GRANT PAYMENTS ARE ALL DUE IN THE NEXT TWO YEARS. GRANTS AUTHORIZED BY CHILD'S PLAY BUT UNPAID AT YEAR END ARE REPORTED AS LIABILITIES. AUCTION 152888 135365 17523 6799 12826 152888 135365 17523 6799 12826 19625 -2102 1 CHILDREN'S HOSPITAL COLORADO FOUNDATION 13123 EAST 16TH AVE BOX 045 AURORA CA 80045 840813462 501(C)(3) 141086 3849 BOOK GAMES & EQUIPMENT RESEARCH GRANT FOR PEDIATRIC GAMING AND TECHNOLOGY INSIDE HOSPITALS. CAPACITY BUILDING GRANT AND GIFT ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO FOUNDATION 225 E CHICAGO AVE CHICAGO IL 60611 363357006 501(C)(3) 85030 4568 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT NORTHWELL HEALTH FOUNDATION 972 BRUSH HOLLOW ROAD 5TH FL WESTBURY NY 11590 112965575 501(C)(3) 84934 2412 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT CMC FOUNDATION OF CENTRAL TEXAS DBA DELL CHILDREN'S FOUNDATION 4900 MUELLER BOULEVARD AUSTIN TX 78723 200468031 501(C)(3) 69500 11908 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT JOHNS HOPKINS ALL CHILDREN'S HOSPITAL 6TH AVE S ST PETERSBURG FL 33701 590683252 501(C)(3) 69000 2869 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT REGENTS OF THE UNIVERSITY OF MICHIGAN 1500 EAST MEDICAL CENTER DRIVE F2519 UH SOUTH ANN ARBOR MI 48109 386006309 501(C)(3) 65000 5972 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT RILEY CHILDREN'S FOUNDATION 705 RILEY HOSPITAL DR RM 4510 INDIANAPOLIS IN 46202 356018517 501(C)(3) 67500 2883 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT BLUE BIRD AUXILIARY 7700 FLOYD CURL DRIVE SAN ANTONIO TX 78229 746035267 501(C)(3) 62463 5245 BOOK GAMES & EQUIPMENT CAPACITY BUILDING AND EQUIPMENT GRANTS AND GIFT UNIVERSITY OF MARYLAND MEDICAL SYSTEM FOUNDATION INC 22 SOUTH GREENE ST BALTIMORE MD 21201 522238893 501(C)(3) 62400 3228 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT THE UPSTATE FOUNDATION INC 750 EAST ADAMS STREET CAB326 SYRACUSE NY 13210 161068101 501(C)(3) 61567 3263 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT KALISPELL REGIONAL HEALTHCARE FOUNDATION 310 SUNNYVIEW LANE KALISPELL MT 59901 311703013 501(C)(3) 54390 4490 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT SUNSYSTEM DEVELOPMENT CORPORATION DBA ADVENTHEALTH FOUNDATION 550 EAST ROLLINS STREET FLOOR 6 ORLANDO FL 32803 592219301 501(C)(3) 52540 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANTS CHILDREN'S HOSPITAL CORPORATION DBA BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVE BOSTON MA 02115 042774441 501(C)(3) 49000 3538 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT JOE DIMAGGIO CHILDREN'S HOSPITAL FOUNDATION INC 3329 JOHNSON STREET HOLLYWOOD FL 33021 650492343 501(C)(3) 48260 2016 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT INTEGRIS HEALTH FOUNDATION INC 3030 NORTHWEST EXPRESSWAY STE 1600 OKLAHOMA CITY OK 73112 731047338 501(C)(3) 44060 3228 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT THE CHILDREN'S HOSPITAL VOLUNTEERS 1200 CHILDRENS AVENUE SUITE 11200 OKLAHOMA CITY OK 73104 237356912 501(C)(3) 43500 2637 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT CLEVELAND CLINIC CHILDREN'S 9500 EUCLID AVENUE CLEVELAND OH 44195 340714585 501(C)(3) 41000 3228 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT GAME TO GROW 12025 115TH AVE NE KIRKLAND WA 98034 821306872 501(C)(3) 38000 0 CAPACITY BUILDING GRANT LEE MEMORIAL HEALTH SYSTEM FOUNDATION INC 9800 S HEALTHPARK DRIVE SUITE 405 FORT MEYERS FL 33908 650645343 501(C)(3) 30000 3908 BOOK GAMES & EQUIPMENT CAPACITY BUILDING GRANT AND GIFT CHILDREN'S HEALTH CARE FOUNDATION 5901 LINCOLN DR EDINA MN 55436 411814223 501(C)(3) 26800 2424 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT CHILDREN'S HOSPITAL 200 HENRY CLAY AVENUE NEW ORLEANS LA 70118 720467503 501(C)(3) 26620 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT CHILDREN'S HOSPITAL FOUNDATION 1 IVENTA PLACE 6TH FLOOR WEST SILVER SPRING MD 20910 521640402 501(C)(3) 26000 1557 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL FOUNDATION PO BOX 156 NEW BRUNSWICK NJ 08903 222378007 501(C)(3) 23325 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION 3011 WEST GRAND BOULEVARD SUITE 218 218 DETROIT MI 48202 320087353 501(C)(3) 19000 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT MERCY HEALTH FOUNDATION ST LOUIS 615 SOUTH NEW BALLAS ROAD ST LOUIS MO 63141 562410020 501(C)(3) 17016 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT INTERMOUNTAIN HEALTHCARE FOUNDATION INC 36 SOUTH STATE STREET SUITE 2200 SALT LAKE CITY UT 84111 800225150 501(C)(3) 7000 11031 BOOK GAMES & EQUIPMENT GIFT TEXAS CHILDREN'S HOSPITAL 6621 PANNIN ST HOUSTON TX 77030 741100555 501(C)(3) 13000 3257 BOOK GAMES & EQUIPMENT GIFT VALLEY PRESBYTERIAN HOSPITAL 15107 VANOWEN STREET VAN NUYS CA 91405 951945832 501(C)(3) 14300 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT NATIONWIDE CHIDREN'S HOSPITAL GROUP RETURN 525 E MOUND STREET COLUMBUS OH 43215 010782751 501(C)(3) 13000 2137 BOOK GAMES & EQUIPMENT GIFT BANNER HEALTH FOUNDATION 2901 N CENTRAL AVE STE 160 PHOENIX AZ 85012 942545356 501(C)(3) 11000 3636 BOOK GAMES & EQUIPMENT GIFT LE BONHEUR CHILDREN'S HOSPITAL FOUNDATION 848 ADAMS AVE PO BOX 41817 MEMPHIS TN 38103 621872938 501(C)(3) 13000 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT OUR LADY OF THE LAKE FOUNDATION 5000 HENNESSY BOULEVARD BATON ROUGE LA 70808 721014324 501(C)(3) 9140 4649 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT CENTER FOR SUICIDE PREVENTION 316 EAST 14TH ST KAUKAUNA WI 54130 461223558 501(C)(3) 0 12754 BOOK GAMES & EQUIPMENT GIFT KAPIOLANI HEALTH FOUNDATION 55 MERCHANT STREET 26TH FLOOR HONOLULU HI 96813 990246364 501(C)(3) 11000 1557 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT CHILDREN'S HOSPITAL & RESEARCH CENTER FOUNDATION 2201 BROADWAY SUITE 600 OAKLAND CA 94612 941657474 501(C)(3) 10000 2424 BOOK GAMES & EQUIPMENT GIFT CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVE CINCINNATI OH 45229 310833936 501(C)(3) 10000 1657 BOOK GAMES & EQUIPMENT GIFT OCHSNER LSU HEALTH SYSTEM - ST MARY MEDICAL CENTER LLC 1 ST MARY PLACE SHREVEPORT LA 71101 850672191 LLC CONTROLLED BY 50 10350 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT THE CHILDREN'S HOSPITAL OF PHILADELPHIA FOUNDATION 3401 CIVIC CENTER BLVD PHILADELPHIA PA 19104 232237932 501(C)(3) 10000 1557 BOOK GAMES & EQUIPMENT GIFT CHILDREN'S MEDICAL CENTER FOUNDATION 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062015 501(C)(3) 9000 2517 BOOK GAMES & EQUIPMENT GIFT GAMERS OUTREACH FOUNDATION INC 108 N MAPLE RD BOX 694 SALINE MI 48176 260321174 501(C)(3) 10500 0 EQUIPMENT GRANT ST LOUIS CHILDREN'S HOSPITAL FOUNDATION 1001 HIGHLANDS PLAZA DR WEST STE 160 ST LOUIS MO 63110 431626863 501(C)(3) 8000 2257 BOOK GAMES & EQUIPMENT GIFT CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 951690977 501(C)(3) 9000 1212 BOOK GAMES & EQUIPMENT GIFT RANKEN JORDAN HOME FOR CONVALESCENT-CRIPPLED CHILDREN 11365 DORSETT ROAD MARYLAND HEIGHTS MO 63043 430666765 501(C)(3) 9000 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT ALABAMA CHILDREN'S HOSPITAL FOUNDATION 1600 7TH AVENUE SOUTH ATTN FOUNDATION BIRMINGHAM AL 35233 630879471 501(C)(3) 8000 1212 BOOK GAMES & EQUIPMENT GIFT ARKANSAS CHILDREN'S HOSPITAL 1 CHILDRENS WAY LITTLE ROCK AR 72202 710236857 501(C)(3) 8000 1212 BOOK GAMES & EQUIPMENT GIFT CHILDREN'S HOSPITAL OF PITTSBURGH FOUNDATION 4401 PENN AVENUE PITTSBURGH PA 15224 251865744 501(C)(3) 8000 1212 BOOK GAMES & EQUIPMENT GIFT CHRISTUS SANTA ROSA HEALTH CARE CORPORATION 100 NE LOOP 410 SUITE 706 SAN ANTONIO TX 78216 741109665 501(C)(3) 7000 2137 BOOK GAMES & EQUIPMENT GIFT OSF HEALTHCARE FOUNDATION 800 NORTHEAST GLEN OAK AVENUE PEORIA IL 61603 371259284 501(C)(3) 9000 0 EQUIPMENT GRANT IOWA HEALTH FOUNDATION DBA UNITYPOINT HEALTH DES MOINES FOUNDATION 1415 WOODLAND AVENUE E200 DES MOINES IA 50309 421467682 501(C)(3) 7000 1792 BOOK GAMES & EQUIPMENT GIFT THE UNIVERSITY OF KENTUCKY 322 PETERSON SERVICE BUILDING 411 SOUTH LIMESTONE LEXINGTON KY 40506 616001218 501(C)(3) 7000 1792 BOOK GAMES & EQUIPMENT GIFT BAPTIST HEALTH SYSTEM FOUNDATION INC 841 PRUDENTIAL DRIVE SUITE 1300 JACKSONVILLE FL 32207 592487135 501(C)(3) 7000 1557 BOOK GAMES & EQUIPMENT GIFT CHILDRENS HOSPITAL MEDICAL CENTER OF AKRON ONE PERKINS SQUARE AKRON OH 44308 340714357 501(C)(3) 7000 1212 BOOK GAMES & EQUIPMENT GIFT CHOC FOUNDATION 1201 W LA VETA AVE ORANGE CA 92868 956097416 501(C)(3) 7000 1212 BOOK GAMES & EQUIPMENT GIFT PUBLIC HEALTH TRUST OF MIAMI-DADE COUNTY FLORIDA 1500 NW 12 AVENUE SUITE 1117 MIAMI FL 33136 591713947 501(C)(3) 7000 1212 BOOK GAMES & EQUIPMENT GIFT MEMORIAL MEDICAL CENTER FOUNDATION 2801 ATLANTIC AVENUE LONG BEACH CA 90806 956105984 501(C)(3) 7000 1212 BOOK GAMES & EQUIPMENT GIFT VANDERBILT UNIVERSITY MEDICAL CENTER 1161 21ST AVE S SUITE D3300 MCN NASHVILLE TN 37232 352528741 501(C)(3) 7000 1212 BOOK GAMES & EQUIPMENT GIFT ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO 225 E CHICAGO AVE CHICAGO IL 60611 362170833 501(C)(3) 8000 0 GIFT SEATTLE CHILDREN'S HOSPITAL PO BOX 5371 MS 818-S SEATTLE WA 981455005 910564748 501(C)(3) 3000 4833 BOOK GAMES & EQUIPMENT GIFT THE NEMOURS FOUNDATION 10140 CENTURION PARKWAY NORTH JACKSONVILLE FL 32256 590634433 501(C)(3) 6000 1557 BOOK GAMES & EQUIPMENT GIFT NYU LANGONE HOSPITALS 550 FIRST AVENUE NEW YORK NY 10016 133971298 501(C)(3) 5250 2037 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT THE JOHNS HOPKINS HOSPITAL 750 E PRATT STREET BALTIMORE MD 21202 520591656 501(C)(3) 7000 0 GIFT THE CHILDREN'S MERCY HOSPITAL 2401 GILLHAM RD KANSAS CITY MO 64108 440605373 501(C)(3) 5000 1792 BOOK GAMES & EQUIPMENT GIFT DUKE UNIVERSITY HEALTH SYSTEM INC BOX 3417 DURHAM NC 27710 562070036 501(C)(3) 5000 1792 BOOK GAMES & EQUIPMENT GIFT ELIZABETH SETON PEDIATRIC CENTER 300 CORPORATE BLVD SOUTH YONKERS NY 10701 133398657 501(C)(3) 5000 1792 BOOK GAMES & EQUIPMENT GIFT PROVIDENCE HEALTH CARE FOUNDATION EASTERN WASHINGTON 101 WEST 8TH AVENUE SPOKANE WA 99202 320014330 501(C)(3) 5000 1792 BOOK GAMES & EQUIPMENT GIFT UNIVERSITY OF CHICAGO 5835 S COTTAGE GROVE AVE CHILD LIFE K135 CHICAGO IL 60637 362177139 501(C)(3) 5000 1557 BOOK GAMES & EQUIPMENT GIFT BAYSTATE HEALTH FOUNDATION INC 759 CHESTNUT STREET SPRINGFIELD MA 01199 043549011 501(C)(3) 5165 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT WAKE FOREST UNIVERSITY HEALTH SERVICES MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 223849199 501(C)(3) 5000 1212 BOOK GAMES & EQUIPMENT GIFT CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION INC 282 WASHINGTON STREET HARTFORD CT 06106 222619869 501(C)(3) 5000 1212 BOOK GAMES & EQUIPMENT GIFT DAYTON CHILDREN'S HOSPITAL FOUNDATION 1 CHILDRENS PLAZA DAYTON OH 45404 311045247 501(C)(3) 5000 1212 BOOK GAMES & EQUIPMENT GIFT CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION 1028 MAIN ST FL 4 BUFFALO NY 14202 161332044 501(C)(3) 5000 1212 BOOK GAMES & EQUIPMENT GIFT STATE UNIVERSITY OF IOWA FOUNDATION 22130-CSFCH 200 HAWKINS DRIVE IOWA CITY IA 52242 420796760 501(C)(3) 5000 1212 BOOK GAMES & EQUIPMENT GIFT CHILD LIFE DISASTER RELIEF INC 2701 LITTLE ELM PARKWAY SUITE 100-460 LITTLE ELM TX 75068 813905287 501(C)(3) 6100 0 EQUIPMENT GRANT YALE NEW HAVEN HOSPITAL 20 YORK STREET NEW HAVEN CT 06510 060646652 501(C)(3) 3000 3032 BOOK GAMES & EQUIPMENT GIFT BELLIN MEMORIAL HOSPITAL INC 744 SOUTH WEBSTER AVENUE GREEN BAY WI 54301 390884478 501(C)(3) 6000 0 EQUIPMENT GRANT BRONXCARE HEALTH SYSTEM 1276 FULTON AVENUE BRONX NY 10456 131974191 501(C)(3) 6000 0 EQUIPMENT GRANT THE PERMANENTE MEDICAL GROUP INC 1950 FRANKLIN STREET 18TH FLOOR OAKLAND CA 94612 942728480 C CORPORATION 6000 0 EQUIPMENT GRANT ST JOSEPH'S HOSPITAL OF TAMPA FOUNDATION INC 2700 W DR MARTIN LUTHER KING JR BLVD SUITE 310 TAMPA FL 33607 591100828 501(C)(3) 6000 0 GIFT RONALD MCDONALD HOUSE CHARITIES OF ESTERN IOWA AND WESTERN ILLINOIS 730 HAWKINS DR IOWA CITY IA 52246 421189783 501(C)(3) 5776 0 EQUIPMENT GRANT GATEWAY WOODS FAMILY SERVICES 14505 KLOPFENSTEIN RD LEO IN 46765 272260443 501(C)(3) 2480 3263 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT PHOENIX CHILDREN'S HOSPITAL FOUNDATION 2929 E CAMELBACK ROAD SUITE 22 PHOENIX AZ 85016 742421549 501(C)(3) 1000 4309 BOOK GAMES & EQUIPMENT GIFT CHILDRENS HOSPITAL & MEDICAL CENTER (OMAHA) 8404 INDIAN HILLS DRIVE SUITE 650 OMAHA NE 68114 476105603 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT RWJ BARNABAS HEALTH INC 201 LYONS AVE NEWARK NE 07112 223452311 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT DOERNBECHER CHILDRENS HOSPITAL FOUNDATION PO BOX 29017 PORTLAND OR 97296 930579589 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT ERLANGER HEALTH SYSTEM FOUNDATIONS 975 EAST THIRD STREET CHATTANOOGA TN 37403 581664027 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT MAINEHEALTH 22 BRAMHALL STREET PORTLAND ME 04102 010238552 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT THE MEDICAL UNIVERSITY OF SOUTH CAROLINA FOUNDATION 165 ASHLEY AVENUE ROOM 701 MSC 355 CHARLESTON SC 29425 576028985 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT SANFORD HEALTH FOUNDATION PO BOX 5039 RTE 5218 SIOUX FALLS SD 57117 363297853 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT SACRED HEART FOUNDATION INC 5151 NORTH 9TH AVE PENSACOLA FL 32504 592436597 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT THE GEORGIA HEALTH SCIENCES FOUNDATION INC 1446 HARPER STREET BT 1844 AUGUSTA GA 30912 352310573 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT THE UNIVERSITY OF VIRGINIA HEALTH FOUNDATION (UVA CHILDREN'S) PO BOX 800008 CHARLOTTESVILLE VA 22908 412097394 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT THE UCLA FOUNDATION 10889 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 952250801 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT SHANDS TEACHING HOSPITAL AND CLINICS INC 1600 SW ARCHER ROAD GAINESVILLE FL 32608 591943502 501(C)(3) 4000 1212 BOOK GAMES & EQUIPMENT GIFT DANA-FARBER CANCER INSTITUTE INC 10 BROOKLINE PLACE WEST BROOKLINE MA 024457226 042263040 501(C)(3) 5200 0 EQUIPMENT GRANT COXHEALTH FOUNDATION 3525 S NATIONAL AVE SUITE 204 SPRINGFIELD MO 65807 436810485 501(C)(3) 3890 1212 BOOK GAMES & EQUIPMENT EQUIPMENT GRANT AND GIFT 93 2 PART I, LINE 2: CHILD'S PLAY REQUESTS A REPORT FROM THE ORGANIZATION DETAILING HOW THEY USED THE FUNDS. PENNY ARCADE INC MIKE KRAHULIK (VICE PRESIDENT) IS AN OWNER OF PENNY ARCADE INC RECEIVABLE FOR TRAVEL REIMBURSEMENT X 2231 0 1 1 PENNY ARCADE INC MIKE KRAHULIK (VICE PRESIDENT) IS AN OWNER OF PENNY ARCADE INC PAYABLE FOR WAREHOUSING X 3285 0 1 1 5516 PENNY ARCADE INC MIKE KRAHULIK (VICE PRESIDENT) IS AN OWNER OF PENNY ARCADE INC 34278 WAREHOUSING 0 FC INDUSTRIES LLC SEE BELOW 70325 RENT 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: FC INDUSTRIES LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: MIKE KRAHULIK (VICE PRESIDENT) AND MIKE HAYES (TREASURER) ARE OWNERS OF FC INDUSTRIES LLC X GAME CODES, CONSOLES, CONTROLLERS 1 209455 FMV X CLOTHING, ART, PINS, GAME ACCESSORIES 1 113847 FMV X GAMES/TOYS/ELECTRONICS/COLLECTIBLES 100 25582 FMV X GAMES, TOYS, AND EQUIPMENT 1 12698 FMV 0 0 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTORS FORM 990, PART VI, SECTION A, LINE 2 MIKE KRAHULIK (VICE PRESIDENT) HAS OWNERSHIP INTEREST IN PENNY ARCADE, INC. MIKE KRAHULIK (VICE PRESIDENT) AND MIKE HAYES (TREASURER) HAVE OWNERSHIP INTERESTS IN FC INDUSTRIES, LLC. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS SENT TO THE BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST ISSUES ARE MONITORED AND ENFORCED AT AN ANNUAL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE DIRECTOR COMPENSATION IS COMPARED TO SIMILAR-SIZED NPOS IN THE AREA AND THE BOARD VOTES AND APPROVES COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.