Rainbow Connection

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Is your Adopt a Dream in the name of a Company or Group Affiliation?

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Adoption Contribution Amount

Please Read and Complete the Following
I / We are interested in participating in the Wish delivery if possible.
I / We wish to remain anonymous to the Wish Child and their family.
I / We do not wish to have any publicity surrounding our 'adoption'.

I / We realize that the completion of the wish is entirely dependent upon the child's condition and his / her physician's approval.

I / We understand that the coordination of the 'Adoption' will be done by the Rainbow Connection. I am aware that the assignment of my 'Adopted Wish Child' will occur as soon as possible however, time parameters may exist.

I / We understand that interaction with the Wish Child and his / her family may not be possible.

I / We understand that any information pertaining to my 'Adopted Wish Child' is to be kept completely confidential unless otherwise specified by the Rainbow Connection Wish Director.

I / We understand the brick paver will be engraved upon completion of the Wish.

I have read and agree with all the terms and conditions of participating in the 'Adopt A Dream' program.

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