Families » Family Information Update

Family Information Update

If you are a Dance Marathon family and have moved or changed addresses recently you may update your contact information here. Or, if you are a Dance Marathon family and you have stopped receiving our mailings, you may fill out this form. This form is NOT for new families to register for Dance Marathon.

Child Information

Child's Full Name

Type of Diagnosis (cancer)

Date of Diagnosis

Date of Relapse (if applicable)

End of Treatment Date (if applicable)

Favorite Color

Interests (will be used to design their pillowcase)

Parent/ Guardian Information

Parent/ Guardian 1 Name

Parent/ Guardian 1 Relationship

Parent/ Guardian 2 Name

Parent/ Guardian 2 Relationship

Preferred Contact Information

Street Address

Apartment Number

City

State

Zip Code

Phone Number

Child Email Address (if applicable)

Parent/ Guardian Email Address

Website (if applicable)

Sibling Information

Siblings' Names

Siblings' Dates of Birth

Additional Information

Which category does your event fit into?

Mini Dance Marathon at a local school
Community Day at a local business
Sporting Event
Other

When did you first start this event?

How many years have you done this event?

Contact email

Are there any questions or additional information that you'd like to leave with us?