Important Information Regarding COVID-19 Click to Learn More
Facebook
Twitter
Linkedin
Instagram
About
Who We Are
Read Stories
Annual Reports
Careers
Partners
Expressions of Gratitude
Proud Partners
Free Resources
Food For Thought
Cancer Knowledge Network
Supersibs Program
Bereaved Families of Ontario
Ontario Renal Network
Love Your Melon
Eating-Related Side Effects
Healthy Choices When Eating Out
Healthy Eating for Any Budget
Programs
Rainy Day Fund
Rainy Day Gifts
Camp Scholarship
Camp Backpacks
The Gift Card Project
Get Involved
Careers
Events
DIY Fundraisers
Raise Funds
Share Your Story
Wig & Hair Donations
Sponsor a Toy Drive
Volunteer
Start Knitting
Donate
Donate Now
Donate Your Car
Bequest
Endowments
Life Insurance
Gift of Securities
Foundation Friends
The Gift Card Project
Contact Us
Menu
About
Who We Are
Read Stories
Annual Reports
Careers
Partners
Expressions of Gratitude
Proud Partners
Free Resources
Food For Thought
Cancer Knowledge Network
Supersibs Program
Bereaved Families of Ontario
Ontario Renal Network
Love Your Melon
Eating-Related Side Effects
Healthy Choices When Eating Out
Healthy Eating for Any Budget
Programs
Rainy Day Fund
Rainy Day Gifts
Camp Scholarship
Camp Backpacks
The Gift Card Project
Get Involved
Careers
Events
DIY Fundraisers
Raise Funds
Share Your Story
Wig & Hair Donations
Sponsor a Toy Drive
Volunteer
Start Knitting
Donate
Donate Now
Donate Your Car
Bequest
Endowments
Life Insurance
Gift of Securities
Foundation Friends
The Gift Card Project
Contact Us
Christmas Part Application 2020
Patient Name
*
First
Last
Patient Age
*
Parent Name (if Patient is 18 or under)
First
Last
Patient Diagnosis
*
Date of Most Recent Treatment
*
Date Format: MM slash DD slash YYYY
Hospital
*
Doctor
*
Home Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email
*
Phone
*
Number of family members attending Christmas Party
*
(Note: Due to demand, please only register the immediate family of the patient to attend)
Names of Attending
*
Number of Children (18 and under)
*
Any dietary requirements (gluten free, nut allergy, kosher, etc.) or mobility requirements (walkers, wheelchairs, etc.)?
*
Yes
No
If yes, name of person and details of the restriction:
Child 1
Name
*
First
Last
Age
*
Gender
*
T-Shirt Size
*
XS
S
M
L
XL
XXL
Hobbies
*
Favourite celebrity/musician/sports team/etc.
*
Wish List Item 1
*
Link to Item 1 on Amazon.ca (optional)
Wish List Item 2
*
Link to Item 2 on Amazon.ca (optional)
Wish List Item 3
*
Link to Item 3 on Amazon.ca (optional)
Child 2
Name
First
Last
Age
Gender
T-Shirt Size
XS
S
M
L
XL
XXL
Hobbies
Favourite celebrity/musician/sports team/etc.
Wish List Item 1
Link to Item 1 on Amazon.ca (optional)
Wish List Item 2
Link to Item 2 on Amazon.ca (optional)
Wish List Item 3
Link to Item 3 on Amazon.ca (optional)
Child 3
Name
First
Last
Age
Gender
T-Shirt Size
XS
S
M
L
XL
XXL
Hobbies
Favourite celebrity/musician/sports team/etc.
Wish List Item 1
Link to Item 1 on Amazon.ca (optional)
Wish List Item 2
Link to Item 2 on Amazon.ca (optional)
Wish List Item 3
Link to Item 3 on Amazon.ca (optional)
Child 4
Name
First
Last
Age
Gender
T-Shirt Size
XS
S
M
L
XL
XXL
Hobbies
Favourite celebrity/musician/sports team/etc.
Wish List Item 1
Link to Item 1 on Amazon.ca (optional)
Wish List Item 2
Link to Item 2 on Amazon.ca (optional)
Wish List Item 3
Link to Item 3 on Amazon.ca (optional)
Please note that we will do our best to fill wish list requests but that we are limited to what we can provide.
Audio/Visual release
I understand that by authorizing this Audio/Visual Release form, I am irrevocably releasing the use of any likeness dialogue which has been recorded of my family for Shine Through the Rain, including its employees, agents or servants for any multi-media purpose that could include reproducing it on our website, or any other printed media associated with the organization, such as promotions, single images, or as wallpaper. All audio/visual records, recordings, negative and/or slides together with any prints shall constitute the property of Shine Through the Rain, solely and completely. Shine Through the Rain respects your privacy. We protect your personal information and adhere to all legislative requirements in protecting your privacy. We do not rent, sell, or trade our mailing lists. We see your personal information to provide services to keep you informed and up to date on our activities.
*
I Accept
How did you hear about the Christmas Party?
*
Comments/Questions
