Project Angel Hugs: New Enrollment
Please fill in the form below to enroll your child. Project Angel Hugs ministers to the emotional needs of children touched by cancer, and their families.
As part of our enrollment process, we do require verification that your child is currently in treatment. Could you please upload one of the following? A letter from your child’s medical team confirming current treatment, or a screenshot or photo of a recent appointment summary or treatment schedule.
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Child's Name
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First Name
Last Name
Child's Mailing Address (complete shipping address below if this is a P.O. Box)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Shipping Address (complete ONLY if mailing address is a P.O. Box)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Birthday
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child's Gender
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Male
Female
If female, please check if ears are pierced
Likes/Dislikes
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Please be as specific as possible! The more information we have about your child’s likes, interests, hobbies, and wishes, the better we can personalize their HUG Box.Some ideas include: painting, drawing, crafts, knitting, puzzles, collections, makeup, hair care, nail care, jewelry, skincare, favorite books, authors, characters or book genres, board games, card games, activity books, favorite brands or characters such as Disney, Minecraft, Pokémon, Barbie, Hello Kitty, Paw Patrol or WWE, as well as interests such as cars, hunting, sports, animals, dinosaurs, science, music and more. You can also tell us their favorite colors, styles, glitter and sparkles, movies, TV shows, sports teams, animals, or anything else they love.If your child enjoys reading, please be descriptive about the types of books they like, including favorite authors, series, characters or genres.Please note that we do not provide games for gaming consoles or systems or gift cards.HUG Boxes are shipped in 12" x 12" x 8" boxes, so please keep the size of requested items in mind. Very large items may not fit.The more information you provide about your child, the better we can personalize their HUG Box and choose items that are truly special to them!
Favorite Color(s)
Favorite Girl Scout Cookies
Favorite Candy
Favorite Sport or Sports' Team
Favorite Animal(s)
Favorite TV Show(s)
Favorite Music Genre
Please check ALL holidays your child wants to receive boxes for.
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Valentine's Day
Easter
Halloween
Christmas
Summer
Birthday
Dad's First AND Last Name
Mom's First AND Last Name
Child's siblings (under the age of 18 in home), please list NAME, AGE and GENDER
Please check each site that you utilize.
Caringbridge
Cole's Pages
Facebook
Personal Webpage
Other
Please list sites checked above so we can stay updated on your child's journey.
Parent/Guardian E-mail
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Do we have permission to use your child's photo in our office? Only your child's first name and last initial will be used.
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Yes
No
Do we have permission to use your child's photo on our website and/or in our social media (Facebook, etc.) accounts? Again, only first names and last initials will be used.
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Yes
No
Child's Diagnosis
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What hospital/healthcare facility is providing your child's treatment?
How did you hear about Project Angel Hugs?
Phone Number
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Area Code
Phone Number
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