BE A PART OF THE HAPPINESS!

• REQUEST A BOX •

🎉Request a Birthday in a Box for a child who is hospitalized on their BIRTHDAY🎉
(US hospitals only)

Welcome! We are so excited to celebrate the special child in your life on THEIR birthday! We know birthdays in the hospital can be hard — and we want to help bring a little joy to those days. our volunteers and donors have come together to make sure your child’s special day is celebrated with love, laughter, and confetti.

🎉Because no matter where a birthday happens… it still deserves to be magical. 🎉

Our birthday boxes are available for children who are:

Celebrating a birthday while admitted to a hospital, pediatric oncology clinic, or hospice facility in the United States.
Under the care of a Child Life Specialist
Between the ages of 1-18 years old
There is zero cost to you or your family if your child is celebrating their birthday in a hospital setting (birthday boxes will NOT be shipped to residential/home addresses, Hospitals ONLY)

🎈 Please note, we need a minimum of 10 days to produce a birthday box, and we can not honor any request that comes before that time. Our HQ is in Rhode Island, and we need adequate time to make your child’s birthday box!

🌟This form is ONLY for Family & Friends, Participating Hospitals (child life staff) can make requests in their Child Life Portals 🌟

Child's Name

First Name

Last Name

Child's age they are turning

Child's Birthday

We CAN NOT honor requests more than 30 days BEFORE the child's birthday

YYYY

Desired Birthday Theme

Gender of Child

Which US hospital/facility are they admitted at?

child MUST be inpatient the day of their birthday or at clinic on their birthday

The child's hospital/clinic mailing address (room number MUST be included)

*Location can ONLY be a United States hospital/clinic/Hospice facility, if room number is NOT available we need the contact information of their Child Life Specialist. We CAN NOT send boxes to personal residences.

Your Name

First Name

Last Name

Your Email

Cell Phone Number

Cell phone number you can be text at on the day of the party

(###)

###

####

Your Relationship to Child (*parent, relative, grandparent)

*please NO hospital/facility staff

Is there a public website/social page that provides updates on the child's progress? If so, please provide the link below:

please share an Instagram handle or Facebook page where you share your child's health journey

Does your Child have an Amazon Wish List started for their birthday? Please provide the link below:

Share with us any details about this special birthday child that would help us get to know this child!

Is there a special message from you that you would like us to include in the birthday box?

How did you hear of our mission?

Send me a Birthday box!

Filling out this form, I am aware I need 10 days BEFORE the child's birthday to get a custom box. (no more then 30 days before) If I do not have 10 days, I will check with my Child Life Specialist to see what Birthday Boxes they have on hand (if they are a participating hospital)

I agree that accepting this gift, I will provide photos/videos of our party!

Yes! I understand I need 10 days to receive a custom birthday box from The Confetti Foundation

Yes! my child will be inpatient or at their clinic receiving services the day of their birthday

Once form is reviewed, we will email you with any further questions and shipping details.

BE A PART OF THE HAPPINESS!

• REQUEST A BOX •

🎉Request a Birthday in a Box for a child who is hospitalized on their BIRTHDAY🎉 (US hospitals only)

🎉Request a Birthday in a Box for a child who is hospitalized on their BIRTHDAY🎉
(US hospitals only)