Hat request

Use the form below.

Hat Request form

To ensure our hats reach children that are battling cancer and in the care of a hospital or other healthcare facility please fill this form out completely. The request must come from a parent or a legal guardian.

Child's Name*
First Last
Gender*
Is the hat for a male or a female?
Childs Birth Date
Type of hat.
To help us select the best hat please tell us a little bit about what type of hat would be best.
T shirt size
If you would like a t shirt for the child let us know the correct size. They are 50/50 shirts
Child's Social media Page (Facebook or Caring Bridge*
We need to be able to look at your either a Facebook or Caring Bridge page that has been set up for you child. If you do not have a support page please send us the name of your Facebook page.
Your Name*
First Last
Your Email*
Phone
Address to send package*
Street Address Address Line 2 City State ZIP Code

We only send hats to children that are residents of the United States.
Are there any siblings? If yes please add their age and gender
Permission to share pictures*
We like to share pictures of the children in their hats on our social media pages (FB, Twitter, Instagram, and website). The pictures show our followers the impact of what we do. By entering yes you agree to allow us to post pictures that you send to us. Please email us any pictures using the highest resolution you can.
Where is the child being treated?*
Type of cancer?*
Comments/ how you heard about Ellie's Hats
If you would like to let us know more about your child please enter that here. How did you hear about Ellie's Hats?
Name
This field is for validation purposes and should be left unchanged.

Hat request

Hat Request form

ELLIE’S HATS

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