Photoshoot Application
Child must be currently in treatment, or within 6 months of treatment to be eligible. Ages 1-23.
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Application Submitted by *
Your Name (First and Last) *
Child’s Name (First and Last) *
Child's Diagnosis *
Date of Child's Diagnosis *
Is your child *
Your Email *
Child's Parent's Email (Leave blank if same as above)
Phone Number *
Child's Birthday (month/day/year) *
Child's Clothing Size (shirt, pants, dress) *
Child's Shoe Size *
Name of Hospital Child is/was treated at *
Name of Child's Social Worker *
Email for Child's Social Worker *
State you currently reside in (Must reside in one of these states, within a 1.5 hour radius from Warwick, RI)
 *
Required
Please indicate the photoshoot type(s) you are interested in: *
Required
If you selected Disney Princess, please indicate princess(s) child is interested in: *
Required
Current Address  *
LINK to Parent/Child Social Media (This MUST be a LINK to a verifiable social media page (Instagram, Facebook and/or Caringbridge This MUST be completed in order to send a doll for verification purposes.) *
Gender of Doll (if your child would like a doll, and does not yet have a doll from us)
Clear selection
Doll Choice
Clear selection
Child’s Story (Diagnosis, Treatment, How they’re doing now, 2-3 paragraphs) *
How did you hear about us? *
Required
Photo and Story Consent *
Required
SMS and Email Opt In *
Required
Comment or Message *
Submit
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