DONATE
REGISTER YOUR CHILD

Register your child

Register your child

Thank you for your interest in NSHELTER. We are so excited you are here. This for is the first step to register your child (ren) for all NSHELTER programsThank you for your interest in NSHELTER. We are so excited you are here. This for is the first step to register your child (ren) for all NSHELTER programs.

Primary Parent/ Guardian

Physical Address

Primary Parent/ Caregiver Demographics

NSHELTER is committed to fostering, cultivating and preserving a culture of diversity and inclusion.
The following questions are completely optional.

Secondary Parent/ Caregiver

Physical Address

Please, share up to two parents/ Caregivers that has been impacted by a cancer in your child(ren)family. When the term parent is used at NSHELTER it includes any parent and guardian with primary or legal responsibility for a child. This includes biological, adoptive and foster parents. It can also includes grandparents or any others relatives in parenting roles.

Family member 1

Please, share where the primary /primary caregiver is/was receiving treatment

Family member 2

Please, share where the primary /primary caregiver is/was receiving treatment

V- Child Information

  • Child 1

  • Child 2

  • Child 3

  • Child 4