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Primary Contact Information

Primary Contact Information


Please Tell Us

Please Tell Us


Nominated Child's Information

Nominated Child's Information










Developmental age is the age at which your child functions emotionally, physically, cognitively and socially.
Later  in the application you will need to upload a copy of the nominated child's birth certificate or most recent shot record to show proof of age.

Address Where Child Resides








Medical Information







Vaccination Information
If none, please leave the following dates blank


Travel Restrictions











Additional Medical Information











Medical Doctor Information

Child's Primary Doctor Information




Other Doctors, nurses, or child life specialists who regularly see your child:
Please create a response for each Doctor, Nurse, or Child Life Specialist by clicking the "Add Another Doctor, Nurse, Child Life Specialist" button at the bottom of this section.



Family Member Information

On the following sections please list all family members members who live in the same household with the nominated child and their relationship to the child. Family members invited to attend the Kidd’s Kids trip are the child’s parent(s)/legal guardian(s) and siblings, between the ages of 4 and 18 years of age, who currently reside in the child’s household.

Only those family members that are eligible and listed on this form will be invited to attend the trip, if the child is selected.

All sections for each family member must be complete (Full legal name, relationship, age, and date of birth). Add additional family members as needed. All family members over the age or 18 years must have a United States Government issued ID in order to attend the trip.
I agree that all adults 18+ on this application have or will have a valid United States issued photo ID or passport in order to board a domestic flight in November 2022.

I understand that if I have a child under the age of 4 (at the time of the trip), they will not be invited to attend the Kidd's Kids Trip. In the event my family is selected, I will make arrangements for them to stay with a family member or friend while we are out of town. 

Parent/Legal Guardian(s) 

Please complete the required fields for each Parent/Legal Guardian
Parent(s) / Legal Guardian(s)








Address Information





Contact Information





Employer Information









Insurance Information




Medical Information




Vaccination Information
If none, please leave the following dates blank


Siblings

Siblings









Medical Information




Vaccination Information
If none, please leave the following dates blank


Other Wish Trips



Wish Information
Please create a response for each wish trip your child has applied for by clicking the "Add Another Wish" button at the bottom of this section.









GKTW




Disclaimer

*Kidd’s Kids verifies all prior Walt Disney World wishes with Give Kids The World. If a child has already been to Disney World through another wish-granting organization, they will NOT qualify for Kidd’s Kids.   


Vacation

Last Vacation


Kidd's Kids Trip Information













Litigation

Litigation


COVID-19 Disclaimer and Protocol

Disclaimer: Because of the COVID-19 pandemic, the Kidd’s Kids selection committee requires medical history for all family members listed on the application. The health and safety of all families and staff who attend a Kidd’s Kids trip is very important to us. By applying for a Kidd’s Kids Trip, you are acknowledging that an inherent risk of exposure to COVID-19 exists in any public place where people are present.
COVID-19 Protocol: COVID-19 protocols from the CDC are ever-changing. You acknowledge and agree that you shall comply with the Kidd’s Kids COVID-19 protocols, determined by the Kidd’s Kids medical team, during the trip, which could include mask wearing, social distancing, COVID testing, vaccinations, and flu shots.

Vaccines: The Kidd’s Kids volunteer medical team strongly advises that all staff, volunteers, and family members (who are eligible) receive a flu shot and COVID vaccine prior to the dates of the Kidd’s Kids trip.

Documentation Upload

**Please upload all documentation at the same time right before you submit the form. If you leave this page your documentation uploads will not be saved**

Kidd's Kids will not accept phots of documents, they must be in a PDF or other office file format. 

Example: Do NOT take a photo of a physician form on your phone and upload the image. 
Nominated Child's Birth Certificate OR Shot Records



Kidd's Kids Medical Questionnaire 

Give Kids The World Medical Authorization

Tax Return

Nominated Child's Photo(s)



Supporting Documentation (Optional)
A letter of support is a letter that can be written by anyone in the nominated child’s life (i.e. nurse, teacher, therapist, family friends, family members). Letters of support do not necessarily help or hurt an applicant, they just give some more information about the child and family being nominated. The child’s parent(s) may also write a letter if they wish to expand on any information listed in the application.

You may submit your application before providing/uploading any letters of support. If you would like to send letters of support after submitting the application, please email them to Lyndsay@kiddskids.org and include the nominated child's first and last name in the subject line.



Once you hit SUBMIT, you will be taken to the signature page where you will be able to review all your answers and make changes, if needed.