King Fights Cancer Foundation Assistance Request Form
If you know a child or have a child that was diagnosed with cancer or a life threatening illness, please fill out this form to request assistance.
Child's first and last name *
Child's date of birth *
Diagnosis *
Email the diagnosis letter to
Your Email Address *
Phone number *
What hospital is the child currently being treated at? *
Social Worker contact information (name, email and phone number) *
Parent(s) or Guardian(s) Names *
Home address *
Name and age of Siblings (if any) *
Child's website or social Media accounts (Facebook, Instagram etc.) *
What do you need assistance with? *
If you chose other; please explain. *
Please let us know how you heard about King Fights Cancer Foundation. *
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