Name: (I will only put first names on the website and hats unless you want me to include the last name.)
Please check the color of the hat you would like:
☐ Navy Blue ☐ White ☐ Grey ☐ Pink ☐ Dark Green
☐ Yellow ☐ Orange ☐ Purple ☐ Red
Please tell me a little bit about yourself. What are your hobbies and interests? What would you like me to paint on your hat for you?
To determine who is eligible for a lid, please provide a short, detailed description of your child's condition that is ACTIVELY being treated.
What is the best way for me to give you your hat? Please let me know if I should come to the Hospital to drop it off or have it delivered to your home.
*If you want it delivered, leave your address so I can mail it to you. **If you want to have a picture of your child on the website wearing the hat, just send a picture of him/her and I will place it under the PAST HATS section with all of the other hats and kids.