Project Child Smiles
Email To sherri@projectchildsmiles.org
Thank you for becoming part of Project Child Smiles. We are thrilled that you have allowed us to be a part of your lives. To help complete the process of matching artist and child we need the following information. Please understand that it is our main goal is to protect the children. All Area's Highlighted need to be filled in to process the application
IMPORTANT:
For the parents: Do we have your permission for the use of your child’s photos for advertisement or special promotions, myspace, and artists pages with complete respect and protection of child? Do we have the permission to share contact information with staff and the paired artist?
INITIALS _ DATE
Any party of PCS staff, family or artist may terminate the match at any time a reason may or may not be given. We ask that you email us with a reason so that we can improve areas of interest on PCS
INITIALS_
I _ (Parent’s Name) give permission for Project Child Smiles Inc to contact my child's doctor for verification of illness.
Dr’s Name and Phone Number
Once matches are complete, it is the responsibility of the parties involved to stay in touch with each other. PCS is not responsible for breaks in communication but will assist in reconnections if communications are lost. Communication must be lost for 3 month minimum for a rematch unless initial contact was never made.. PCS must be notified in writing if a rematch is requested or additional assistance in contact is needed.
INITIALS _
All donations to PCS are used for all children and will not be used individually unless approved by PCS staff. If cash or materials are given to child from artist- it is a considered a gift to them. We do not encourage or support any transaction of cash to help families if it is given will be between t the two parties PCS will take no responsibility.
The following information is needed to process this application: The information will be shared with the following parties Project Child Smiles and child’s artist All information traded will remain confidential.
CHILD Name:
DOB (for birthday wishes) and AGE
Parents/Guardian name:
Address/City/State/Zip:
Email Address: _
Phone number:
Websites Myspace URL/Messenger ID's (if any):
Diagnosis of child and status (Mandatory)
Music
of interest (country, rock, rap etc)
Parent/Guardian Signature:
Thank you for joining our family. We look forward to getting to know you and your family
Sincerely
Mary Meadows Founder
Sherri Dorough Co Founder
Project Child Smiles Inc.
Project Child Smiles thanks you for the participation in this program.