Please review the following guidelines for group visits. Once you have finished, click the box to acknowledge that you will comply with the hospital guidelines.
Yes, I have reviewed the information and can comply with the guidelines.
Items marked with an * are required information.
Group's purpose or mission:
(Maximum characters: 2000) You have characters left.
Number of members in your group:
(No more than 14, please)
Help unloading the items to be brought into the hospital
Information about fund raising
Information about making a donation of money
Information about making an in-kind donation
Information about helping with a fund raising or hospital promotional event
Click the button below to submit completed form.
If you have any questions please contact Judi Martin, Child Life Coordinator, 859-323-6551 or firstname.lastname@example.org.
You can also print out this form and mail it here:
Attn: Judi Martin, Child & Family Life CoordinatorKentucky Children’s HospitalRoom HA 4441000 South LimestoneLexington, KY 40536-0293