XA Tickets - Request Form
Patient families: Please use this form to request tickets (XA tickets) to various performing arts concerts in the DC/MD/VA area (available concerts: TheXAProject.org/XA-tickets). We will make our best effort to accommodate requests. You will be notified by e-mail about your request. The XA Project e-mail: info@TheXAProject.org. [All responses are confidential]
Email address *
Parent's Name *
Your answer
Parent's Phone Number *
Your answer
What concert does your family wish to attend? *
Your answer
How many tickets does your family need? *
What hospital is your child receiving treatment? (Check all the apply) *
Required
Do you need wheelchair accessible seating? *
How did you hear about The XA Project? (check all that apply) *
Required
In a few words, what would attending this concert mean to you and your family? (This help us determine ticket distribution)
Your answer
A copy of your responses will be emailed to the address you provided.
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