Kid Wraps

Request a Kid Wrap

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

NOTE: THIS FORM IS NOT FOR CRANIAL BANDS,
IF YOU ARE REQUESTING A CRANIAL BAND WRAP, CLICK HERE!

(If you need to apply for our FREE Kid Wraps program, please click here)

Your Full Name:
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 only take place at our facility in MADISON, WISCONSIN

Phone:
Email:
How Did You Find Us?
Desired Installation Date(s):
 

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


Check here if you are interested in donating to the Kid Wraps program personally or through your business to help other kids smile. Also, visit our "How to Help" Page for more information
 
I feel that 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 to Monarch Media Designs 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 I am receiving a special rate for my project.
   

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

   
 

Copyright © 2002-2016 Monarch Media Designs LLC
Web Hosting by  MonarchWebStore.com
Home of the Kid Wraps by Monarch program