Give Now!

Refer a Child

Anyone can refer a child to our wish granting program – a family member or friend, nurse, doctor or social worker. Please provide as much information as possible, particularly the child’s full name and parent/guardian contact information. You may also leave your contact information in case we are unable to reach the family. Thank you for your gift of caring.

PLEASE NOTE: There are several required fields in order to facilitate your referral, as indicated by the *asterisk*. If you are unable to fill these fields in, please feel free to call us with your referral, toll-free, at 888-918-9004.

Your Name*:

Relationship to child*:

How did you hear about us?:

Parent or Guardian Name (type 'same' if not different from the name field*:

Child's Name*:

Address:

City:

State*:

Zip Code:

Has the child had a wish granted before by ANY wish granting organization?:

What is the age of the child?:

Can the child communicate his or her wish either verbally, with switches, communication boards, or sign language? If yes, how?:

Family Phone*:

Your Phone*:

Your Email*:

Comments (If referring a child, please make sure you tell us the child's full name here):

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Please enter the digits you see above.

114,912 kids helped this last fiscal year through our many programs and services.

Our Mission

Kids Wish Network is an international charitable organization dedicated to infusing hope, creating happy memories, and improving the quality of life for children having experienced life-altering situations. Kids Wish Network assists children and their families through several key programs.

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