Join

the Candlelighters NYC family

 

Sign Up Form

Candlelighters NYC is open to all families with children who have or have had cancer in New York City. All of our events and outings are completely free for our families. If your child, or a child that you know, was recently diagnosed with cancer, we are here to help. Please fill out this form to join the Candlelighters NYC family.

    Child's Full Name (required)

    Child's Date of Birth

    Child's Nickname

    Type of Cancer

    Hospital

    Date of Diagnosis

    Child's Website

    Status Of Treatment

    Other Relevant Health Info

    Family/Parent Name(s)

    Relationship with Child

    Home Address

    Home City

    Home State

    Home Zip

    Home Country

    Home Phone

    Email Address

    Mobile Phone

    Emergency Contact Name

    Emergency Contact Relationship

    Emergency Contact Home Phone

    Emergency Contact Work Phone

    Emergency Contact Mobile Phone

    Sibling Names(separate with commas)

    Sibling Genders

    Temporary Housing Name

    Temporary Housing Address

    Temporary Housing City

    Temporary Housing State

    Temporary Housing Zip

    Temporary Housing Phone

    Length of Time in Temp Housing

    Who told you about Candlelighters? We would love to thank them.

    Testimonial

    We met Barbara from Candlelighters, NYC through another family from our area who had treatment at Memorial Sloan Kettering Cancer Center in NYC.  We literally met her when Trevor was having surgery.  She came to the hospital with blankets and pillows for Marc and I to sleep on while Trevor was in the Pediatric Intensive Care Unit recovering.  She brought Trevor toys to make him smile when he came out of surgery.  Barbara, her husband Stewart, and her sweet dog Uno welcomed Ava, Trevor, Marc and I into her home on many occasions and treated us like family.  Barbara is a wonderful person who does amazing things for kids and their families being treated in the NYC area.  It’s tough to be away from family for treatment.  We think of them as our NYC family.  We can’t thank them enough for their love, support, advice, gifts and the little creature comforts (like a nice glass of wine).

    Sara Elizabeth Schweigert