Eligibility Requirements for Great Escapes

To be eligible for acceptance into the Great Escapes family activities program, a child must have a serious illness or a severe chronic medical condition that significantly affects their day-to-day existence. To be considered medically eligible for the program, a child must have a medical illness or condition that falls within one of the following categories:

• Applicant has a life threatening medical illness
• Condition significantly restricts mobility
  
• Pain and discomfort from the condition cannot be controlled or surgically repaired
  
• Condition requires significant and ongoing medical treatment
  
• Condition is progressive
  
• If the condition is not progressive, it must be current 
   

Apply today to request that your family be enrolled in Starlight's Great Escapes program by completing our English-language membership form or Spanish-language membership form and HIPAA form.

Return completed forms to:

Starlight Children's Foundation Arizona
4397 W. Bethany Home Rd. #1243
Glendale, AZ 85301