Annual T-Shirt Name List
Please complete this form to have your child's name added to the annual BOS T-shirt! 
If your child's name was on last years shirt, you do NOT need to complete this form again.  

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电子邮件地址 *
Parent/Guardian Completing Form *
BOS Patient's FIRST Name & LAST INITIAL  *
Please carefully spell the BOS Patient's FIRST name & LAST INITIAL (last initial will only be used if there are duplicated first names).  The name will be copied and pasted to the back of t-shirt from this submission.
Does the BOS Foundation have your permission to use the BOS Patient's FIRST name on the back of ANY future  BOS shirts? *
Was your child clinically or genetically diagnosed with BOS? *
When was your child diagnosed ?
Thank you!
We appreciate your support!

Raising awareness is very important to helping ensure early and accurate diagnosis of Bohring-Opitz Syndrome.

info@bos-foundation.org | www.bos-foundation.org

**All information on this form is kept confidential and used solely for the purpose of the t-shirts**
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