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)

• Membership Form Package - Western WA (includes all forms above)
• Membership Form Package - Inland Northwest (includes all forms above)
• Membership Form Package - SW WA & OR (includes all forms above)

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.

More information

Is Your Family Eligible to Participate Great Escapes?

Great Escapes_PriorityCode & No Show Policy