Kid Wraps

Request a Cranial Band Wrap

Do you know an awesome kid that could use a little something special to make them SMILE?
We would LOVE to hear from you! Just fill out this form!

(Note: If you need to apply for our FREE Cranial Band Wrap program,
please click here to fill out the correct form.)

*=Required Information

Your Full Name*:
2017 INSTALLATION DATES


We setup a special day on the 3rd or 4th Monday of each month just for Kid Wraps. Dates other than the ones listed may incur an installation charge of $25-50 depending on our current schedule.

March 27th June 26th
April 24th July 31st
May 22nd August 28th
   
Check here if you cannot make any of the listed dates, and will need to setup a custom installation date.
Custom Date Needed: (Please list 2 possible dates)
Date #1 Date #2
I Am a:
   
Child's Name*:
Child's Age*:
Child's Gender:
   
Home City, State*:


NOTE: We are unable to fulfill installation requests outside of the state of Wisconsin at this time because installations must take place at our facility in MADISON, WISCONSIN.

Phone*:
Email*:
How Did You Find Us?*:

Please tell us a little bit about his/her story, why you would like this service, and any other information that would be helpful for us to know*:

BAND MEASUREMENTS

Click Here to Watch the
"How to Measure for a Kid Wrap" Video

(will open in separate window)

 
OPEN SIDE


FRONT inches
BACK inches
LENGTH inches
   
NOTE: if you do not submit measurements at this time, you MUST submit them as soon as you have the band and prior to your installation appointment or it may delay your installation date
 
DESIGN CHOICE
Click Here to View the
Design Gallery

(will open in separate window)
   
Design Style*:
Describe custom design (if applicable):

*Cost includes designs in our design gallery. $25-50 additional charge for custom designs

   
Font Style:

*$25 charge for adding name to band in fonts listed in design gallery

Check here if you are interested in donating to the Kid Wraps program personally or through your business to help other kids smile.
I have read the "How It Works" page, and I fully understand the rules and guidelines of the Kid Wraps program.
I have visited and LIKED the Kid Wraps Facebook Page and Monarch Media Designs Facebook Page
~
I agree to post or send photos after graphic is installed that may be posted on our website or Social Media photo galleries
I understand that this is a voluntary service provided by Monarch Media Designs. Design, production, and installation is done as allowed by our production schedule.
I understand that rules/restrictions apply to every circumstance, and not every application for the FREE service can be accepted.
I understand that I am receiving a special base rate of Only $50 ($100 off standard cost)
I understand that if I want a custom installation date and/or design that is not shown in the Kid Wraps design gallery, there will be an additional $25 - 50 setup fee.
   

After you submit this form, please send photos of the band to info@kidwraps.org with your Name.

       

Thanks for taking the time to visit our site---making kids smile, one wrap at a time!

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