Private Appearance Request
Please provide as much information as possible. While we do our best to accept as many requests as possible, we are unable to do them all. 
Sign in to Google to save your progress. Learn more
Contact Information
Contact Name:  *
Contact Email Address: *
Contact Phone Number: 
Private Visit Details
What is the child/patient's name, age, and gender identity?
You may choose to disclose this information at a later time, once more details of the visit have been arranged, if you are uncomfortable sharing this information now. 
What is the situation of the child/patient you are requesting a visit for?
Please provide as much detail as possible within the limits of what you are comfortable disclosing. 
Where would you like us to visit the child/patient?
Do we need any special clearance or permission aside from the consent of a parent or guardian?
Clear selection
If you answered yes above, please specify what permissions we will need to visit. 
For example, if we are visiting a child in the hospital, do we need to contact the hospital? 
Are there special considerations we need to take when visiting the child/patient?
Things such as wearing masks, shoe coverings, being Covid tested before, etc. 
Clear selection
If you answered yes above, please specify what special considerations we will need in order to visit. 
What date(s) are you requesting a visit?
 Is this date flexible? If so, please provide additional date options.
Characters, Props, & Miscellaneous 
What character(s) would the child/patient be most excited to see?
Please provide more than one option if you are able to. We cannot guarantee what volunteers will be available. 
Are there any prop restrictions?
Can fake weapons that complete a costume be used? Are there any specific fake weapon restrictions, such as no guns? (Examples include Captain America's shield, Wolverine's claws, Thor's hammer or axe, Wonder Woman's lasso, etc.) Please list any special restrictions here.
What sort of toys/games/books does the child/patient like?
We always do our best to bring at least one gift for the visit, often a coloring book and crayons or a book or small toy that matches the character the theme. 
Do you (the person arranging the visit) have any specific requests for our visit?
We will do our best to accommodate special requests, but please consider that our funds and time are limited because we are solely volunteer and donation based. 
We DO NOT take payment for our appearances to community or charity events. We appreciate donations but they ARE NOT REQUIRED

We do not do personal events such as birthday parties unless the child has a physical disability, cognitive disability, or illness.
*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy