2026 Request for Emergent Assistance

2026 Request for Emergent Assistance

Application deadline: October 5, 2026
The Love Fund for Children bridges the gap in youth services by partnering with advocates to fulfill the unique, unmet needs of children across Kansas City.

Professional youth advocates may use this application to apply for Life Essentials items including, but not limited to, beds/bedding, baby items, clothing, medical equipment and therapy services. Visit www.fox4lovefund.org/faq for a comprehensive list of the types of assistance the Love Fund provides.

Children must be 0-18 years and reside in the 14 county Kansas City Metropolitan Statistical Area to be eligible for assistance. A family can receive assistance once per calendar year. Requests over $500 are reviewed bi-monthly and require additional documentation.

The Love Fund for Children reviews applications in the order they are received. Youth advocates will receive a confirmation email letting them know that their application has been received. Communications from the Love Fund must be replied to within 30 days or the case will be withdrawn.

Questions: info@fox4lovefund.org

BACKGROUND FOR EMERGENT NEED
Explain why this is an emergent need and why other resources cannot fulfill this need. For medical items, please include the child's diagnosis, other funding resources the family has pursued (including insurance), and the outcome.*
How will these items/services impact the child and the family?*

REFERRING PROFESSIONAL INFORMATION

Only professional youth advocates can apply. Please include your direct contact information.
Please provide a direct phone number, NOT the agency general line. Provide the mailing address where vouchers should be sent.*
SUPERVISOR INFORMATION

By completing the information below you are confirming that your supervisor is aware of and has approved this request.

CLIENT CONSENT AND RELEASE

Completion of this section is required by the child(ren)'s guardian in order to receive assistance.
Waiver and Release of Liability
I, Guardian Name*, hereby release and forever discharge the Love Fund for Children, its employees, agents, sponsors, affiliates, volunteers, and officers (collectively "Love Fund") from and against all claims and damages of any type that arise from or are related to the materials, equipment, services, goods, or other items or assistance provided by the Love Fund, including but not limited to malfunction, performance, defeat, injury, or any other matter, related in any way to the Recipient(s)' receipt or use of the item. I further understand that it is the sole responsibility of the Recipient(s)' legal guardian(s) for maintaining, repairing, or disposing of any items received; accepting said items absolves the Love Fund of all responsibility. Any additional costs that may be incurred except those explicitly stated on the voucher, are the Recipient(s)' legal guardian(s)' responsibility. All installations, assembly, and use, including equipment installations, must comply with current building codes and all applicable laws and regulations; the Love Fund is not responsible for ensuring compliance with any regulations.
Permission to Contact
Guardian: I grant the Love Fund's employees, representatives, and officers permission to contact the Recipient's guardian directly for clarification, confirmation of receipt, marketing, or other purposes.*
Guardian's Typed Full Name Serves as Signature
Statement of Truth
Guardian: I guarantee that the information included in the application is true to the best of my knowledge. Further, I understand that the presence of inaccurate information in this application could result in the need for reevaluation of this application by the Love Fund. *
Guardian's Typed Full Name Serves as Signature
Guardian: I acknowledge that I have read the above and fully understand its contents by signing below. Applying professionals can sign on the guardian's behalf if the guardian has read and approved all releases.*
Guardian's Typed Full Name Serves as Signature
Date*
Referring Professional: I acknowledge that I have read the above and fully understand its contents by signing below.*
Referring Professional's Typed Full Name Serves as Signature
Date*

PUBLICITY AND PHOTO RELEASE

Guardian approval of this release is NOT required for your application to be considered by the Love Fund.
I, Guardian Name,, hereby give permission to the Love Fund for Children ("Love Fund") and its representatives to use photographs, letters, email messages, audio recordings, information and/or video footage of me and/or my children in publications, presentations, websites, and/or other promotional materials.

I understand that this data may be used for multiple purposes, including but not limited to informing families, donors, media, and the general public about the Love Fund and its programs, services or events. I also acknowledge that neither I nor my child(ren) will receive any compensation for the use of such images, video, audio, likeness, and other similar and/or related content.

I hereby release the Love Fund and its representatives for all claims and liability relating to the use of my or my child(ren)'s name, images, video, likeness, voice, appearance, and other similar and/or related content. I understand this authorization shall continue until terminated by written notice by the Love Fund.

I represent that I am the guardian of the applicant(s) and that I have read and fully understand the terms of this release.
Photo/Publicity Release Guardian Approval
Guardian's Full Name Serves as Signature
Date
YesNo
Should be Empty:

2026 Request for Emergent Assistance

CHILD INFORMATION

BACKGROUND FOR EMERGENT NEED

FAMILY INFORMATION

REFERRING PROFESSIONAL INFORMATION

SUPERVISOR INFORMATION

CLIENT CONSENT AND RELEASE

Waiver and Release of Liability

Permission to Contact

Statement of Truth

PUBLICITY AND PHOTO RELEASE