Before you begin the application, please read the following carefully: By checking the box below, I acknowledge that Front Row Foundation, to fulfill its mission, must take reasonable care to verify its potential recipients suffer from a life-threatening illness. Accordingly, Front Row Foundation requests that individuals submit an application through this website (the “Application”) if they wish to nominate themselves or another individual for a front row experience.
I acknowledge and agree that (1) I wish to submit an Application on my own behalf or on behalf of an individual over 18 years of age, or (2) I wish to submit an application on behalf of my child and I am the child’s parent or legal guardian.
If I wish to submit an Application on behalf of my child, by checking the box below, I hereby consent to the Front Row Foundation collecting, using, and disclosing my child’s Recipient Information (as defined below).
I understand that the Application may require that I submit personal information about myself or my child. I acknowledge that I must provide my name, mailing address, e-mail address, and telephone number. I further acknowledge, if I am submitting an Application on behalf of my child, that I must provide the following information about my child: my child’s name, birth date, diagnosis, past and present treatment regimen, facilities where treatment occurred or is occurring, identification of treating physician and treating physician contact information, prognosis or projected condition, and information concerning my child’s individual experiences in dealing with the health condition (the “Recipient Information”).
I understand the Recipient Information is used by Front Row Foundation staff to evaluate whether an individual is eligible for a front row experience, including deciding whether an individual has a health condition that Front Row Foundation determines is qualified for a recipient experience.
I understand that Front Row Foundation may also contact the individual’s treating physician and discuss the individual’s diagnosis and projected condition for purposes of evaluating the individual’s eligibility.
By checking the box below, I am representing to Front Row Foundation that I am the parent or legal guardian of any child for whom I have provided Recipient Information.
Front Row Foundation prides itself on telling the stories of each and every Recipient. In order to do so, there are high levels of photography, videography, and interview sessions before, during, and after every single Experience. If this is something the individual you're submitting an application for would not be okay with, this may not be a comfortable process for your loved one. Should they be selected, we will require recorded interviews, photographs, and video throughout the process, which allows us to share the experience with you and your family, along with our extended community. We thank you in advance for giving this careful thought and consideration on behalf of your loved one.
In order to best serve the person you are nominating, we need to know his/hers Family Contact Info...
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