Spirit of Children - Enrollment Form
Spirit of Children had another record breaking year collecting over $4.0 Million in cash and merchandise for Child Life departments in 130 children's hospitals across the U.S. and Canada.
A huge thank you to our dedicated and loyal customers and vendor partners for all of your support.
Please continue to stop by for updates on our 2014 program.
HOSPITAL INFORMATION
 
 
 
 
 
 
 
 
 
Do you have a Child Life department?
Yes      No  
 
Number of in-patient beds
 
Number of pediatric out-patients per year
 
CHILD LIFE CONTACT INFORMATION
First Name
 
Last Name
 
Title
 
E-mail Address
 
Confirm E-mail Address
 
Phone Number
 
EXT.
Primary contact  
 
PUBLIC RELATION CONTACT INFORMATION
First Name
 
Last Name
 
Title
 
E-mail Address
 
Confirm E-mail Address
 
Phone Number
 
EXT.
Primary contact  
 
DONATION/FOUNDATION CONTACT INFORMATION
First Name
 
Last Name
 
Title
 
E-mail Address
 
Confirm E-mail Address
 
Phone Number
 
EXT.
Primary contact  
 
UPLOAD YOUR HOSPITAL'S LOGO
Yes, Spirit Halloween may use this logo on in-store signage
Note: File should be in one of the following formats:
A black and white EPS or AI. The file resolution should be 300 dpi and a minimum of 4" wide.
SETUP LOGIN INFORMATION
E-mail Address
 
Password
 
Confirm Password
 
Click here for Program Rules and Requirements.