Request for Birthday in a Box for a Hospitalized Child (USA Only)
*we require a minimum 7 days notice to assure our box will get to the recipient in a timely manor. All boxes ship from our headquarters in Rhode Island.
Child's name *
Your answer
Child's Age *
Your answer
Child's Birthday *
MM
/
DD
/
YYYY
Desired Birthday Theme *
Which U.S. hospital are they admitted at? *
Your answer
The child's mailing address (location can ONLY be a United States hospital) *
Your answer
Your name *
Your answer
Your email *
Your answer
Your relationship to the child *
Your answer
Special message you would like us to include in the birthday box
Your answer
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