CureSearch Testimonials: Share Your Story

At CureSearch, we love to hear from our supporters! We often feature your stories on our homepage, in our News section, and in our Meet the Children and Meet the Supporters profiles.

If you are interested in sharing a story with us about your experience at a CureSearch event, or about loved one's childhood cancer journey, please fill out the form below and we will contact you for more details.

* required information
  
Your Contact Information
First Name:*
Last Name:*
Email:*
Address Line 1:
Address Line 2:
City:
State:
ZIP/Postal Code:
Phone:*
Please give us a brief summary of your story in 2-3 sentences.:*
Name of Child:
Child is (choose one):
Type of Childhood Cancer:
Age at Diagnosis:
Are you 18 years of age or older?:* Yes
No
Parent or Guardian First Name:
Parent or Guardian Last Name:
Parent or Guardian Email:
Parent or Guardian Phone:
Iím the legal guardian of the aforementioned minor & consent to the use of this information by CureSearch for Children's Cancer: I Consent
I Do Not Consent
Image #1: Click here to attach file
Image #2: Click here to attach file
Image #3: Click here to attach file
Consent (please read before checking):* By checking this box, I acknowledge that I have read, understood and agree to the terms and conditions of "Share Your Story" and agree to be bound to them.
        


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