Thank you for adding your "little hero" to our Wall of Courage! Please fill out the form for your child below. You can also send us your Wall of Courage submission and photo via mail at: P.O. Box 6038, Lakeland, FL 33811. We cannot promise the return of pictures!
Fields marked with an * are required.
About your child
First name*
Middle name
Last name
State
Born
Diagnosed
at stage
Tell us something special about your child
Child's photo (JPEG image should be about 200x300 and less than 100k)
Can the Caylee's Hope Foundation use information about your child in newsletter and other publications?