#CareForSeniors Giveaway
Nominate a resident of a long-term care or retirement home. Tell us their story and why you want to brighten their day with a curated care package just for them.
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Email *
Your Name: *
Phone #: *
Name of Resident: *
Name of Resident LTC or Retirement Home: *
Tell us about the resident. How have they been keeping busy during these trying times? Why do you want to nominate this resident. (Please keep to 150 words max) *
Relationship to Resident: *
Thank you for nominating!
We invite you to read more about how COVID-19 has impacted seniors here: https://continyoucare.com/careforseniors-giveaway/


*Canadian residents only, excluding Quebec. Giveaway closes at 11:59PM EST on April 30th, 2021. Receipients will be contacted by email no later than May 15th, 2021. Care Packages will be curated and shipped to resident in their retirement home / long-term care home. Estimated value is $50 CAD with a maximum of 5 care packages. The selection will be made by the Continyou Care team upon reviewing all the submissions.
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