Share Your Child's Cancer Story

Every child has a unique personality and a story to tell, and thousands of shavees and volunteers will be moved to action when they read about your child. Please take this opportunity to introduce yourself or your child to the St. Baldrick’s community and allow volunteers to participate in honor of your child.

Thank you for your interest in sharing your story with the St. Baldrick's Foundation. Please provide information about yourself or your child in the fields below.

Who is Registering the Child

Who is Registering the Child:

Child's Legal Guardian

Legal Guardian:
  • I am the child's legal guardian
  • I am NOT the child's legal guardian

Legal Guardian Contact Information

Legal Guardian Phone Number:
- -
Legal Guardian Email Address:

Your Child's Story

Your Child's Name:

Please enter the child's name as you would like it to appear on the Website. If the box is left blank, or if the child is under 18, only the first name and last initial will be displayed.

Website Display Name:
Gender:
  • Male
  • Female
Country:
City:
State:
Province/Territory:
Region:
Birthdate:
The birth date will not be made public.

Diagnosed:
Age:   Year(s)    Month(s)   In: 
Type Of Cancer:
  • Acute Lymphoblastic Leukemia (ALL)
  • Acute Myelogenous Leukemia (AML)
  • Brain or Spinal Cord Tumor
  • Clear Cell Sarcoma of the Kidney
  • Ewing's Sarcoma
  • Germ Cell Tumor
  • Hepatoblastoma
  • Hodgkin's Disease
  • Lymphoma
  • Neuroblastoma
  • Non-Hodgkin's Lymphoma
  • Osteosarcoma
  • Retinoblastoma
  • Rhabdomyosarcoma
  • Wilm's or Kidney Tumor
  • Diagnosed as an adult with a form of childhood cancer
  • Other
Treated At:
Treatment Status:

Survivor:

  • Cancer-Free
  • In Remission
  • In Treatment
  • In Maintenance
  • Other
 

Deceased:

  • Angel
  • Passed Away
  • Other

Please write one or two paragraphs about your child. Describe his/her personality, likes and dislikes, hobbies, etc.

Website Message:
What does it mean to be an Honored Child?
St. Baldrick's volunteers may choose a child to honor and proudly include them on their St. Baldrick's webpage, helping their donors understand why they are involved. These participants may contact you, but only through the St. Baldrick's Foundation's secure website; they do not have access to your email address or other personal information.
I would like to receive messages from participants who are honoring my child.
I would rather not be contacted by St. Baldrick's participants.
Photo:


  

If you do not have a photo to provide, please select from the default images below.

Photo Submission Policy

Please read the photo submission policy and click to accept below.



   I Accept

Login Information

Username:
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Password:
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  I do not have a St. Baldrick's Foundation username and password.

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Login Information

Username:
Password:
Login Reminder Security Question:
Login Reminder Security Response:

My Contact Information

Title First Name M.I. Last Name Suffix
Address Type:
  • Home
  • Business
Business Name:
Job Title:
Country:
Address (Line #1):
Address (Line #2):
Address (Line #3):
City:
State:
ZIP Code:
Primary Phone Number:
- -   ext
Secondary Phone Number:
- -   ext
Province/Territory:
Postal Code:
Primary Phone Number:
- -   ext
Secondary Phone Number:
- -   ext
Region:
Postal Code:
Primary Phone Number:
011- -   ext
Secondary Phone Number:
011- -   ext

The St. Baldrick's Foundation relies on volunteers to raise funds and does not solicit donations directly by mail or email. News is shared most cost effectively by email, but only with your permission, and we make it easy for you to opt out at any time.

The St. Baldrick's Foundation does not sell or exchange email lists with anyone. (See our privacy policy.)

Primary Email Address:
Secondary Email Address:
I want to stay up-to-date about what's happening at St. Baldrick's; please send me news by email!
Email me only about the St. Baldrick's event in which I am participating, nothing more.
I do not have an email address.

More About You

I am a(n):
  • Adult
  • Child/Minor
Age Range:
  • 4-9
  • 10-13
  • 14-18
  • 19-21
  • Over 21
Gender:
  • Male
  • Female
Occupation:

More About You: Student Information

I am a(n):
School Name:
I am a member of a fraternity or sorority.
Fraternity/Sorority Name:

More About You: Educator Information

I am a(n):
School Name:

More About You: Military Personnel Information

Current Status:
Service Branch:
Unit Information:

More About You: Other Occupation Information

Industry:
Business Name:
Job Title:
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The St. Baldrick's Foundation is a non-profit 501 (c)3 organization, IRS identification number 20-1173824.
Donations made to the St. Baldrick's Foundation are tax deductible in the U.S.