Hi there! By completing this form, you’re signing up for this SunriseVX event or program. Plus, you’ll be able to optionally join any of our other virtual events throughout the year—including monthly events and our summer camp—all free of charge!
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Relationship |
Phone | Ex: 303-555-5555 |
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How would you prefer to be contacted?
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Preferred Name |
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Date of Birth |
School |
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Grade | 2024-2025 School Year |
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Season Of Interest | |
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Describe Your Child |
Hospital Affiliation
Hospital Affiliation (other)
Is this child a child with cancer or a sibling?
If the child with cancer is not attending, please list their name
Initial Diagnosis
Diagnosis Date
Is your child currently on active treatment?
(If no) Date of Last Treatment
By signing below, I acknowledge that I have reviewed and agree to the terms and conditions listed for participation in SunriseVX's virtual programs.
ELIGIBILITY REQUIREMENTS:
– Any child aged 3 to 16 who is within the first five years of cancer diagnosis or treatment.
– Any sibling of a child who meets the above criteria.
PERMISSIONS:
– I acknowledge and accept that my child(ren)/family may be participating in video activities and webinars that may include them being seen and heard on a webcam over the internet.
– I acknowledge and accept that SunriseVX/Sunrise Association will be using a third-party platform like Zoom to facilitate video sessions and I agree that Sunrise VX/Sunrise Association assumes no liability for any performance issues with Zoom or any other third-party software.
– I will encourage my child(ren) to follow appropriate online conduct as explained to them and written in the parent manual or risk losing privileges to participate.
– I acknowledge and accept that others may see our home environment during live sessions.
– By allowing your child to participate in our virtual programs, you are granting Sunrise Association Camps the right to use such images and/or recordings. I acknowledge and accept that virtual camp program sessions may be recorded from time to time, and that all or portions of such recordings/images may be used for purposes including but not limited to sharing with children and families, staff and/or potential staff, teaching and training, and/or marketing/fundraising.