New Starlight Family Sign Up Information
Please submit the following 7 pages to become part of the Starlight program:
1. Great Escapes Family Activities Membership Form (2 pages)
2. Great Escapes Membership Agreement (2 pages-must be signed on second page)
3. Great Escapes Questionnaire (1 page)
4. Authorization for use/disclosure of protected health information (1 page)
5. Code of Conduct (1 page)
Return completed forms listed in 1-5 above to Starlight Northwest by mail to 5001 150th Ave. NE, #110, Redmond WA 98052 or by fax to 425-883-9023.
Is Your Family Eligible to Participate Great Escapes?
Great Escapes_PriorityCode & No Show Policy