Child Life Services

Hasbro Children's Hospital

Special Events and Entertainment Application

Please use the form below to be considered for a special event visit at Hasbro Children's Hospital.

Please read our Special Events and Entertainment Guidelines for information about our policies concerning these visits.

Thank you for your interest in helping to make a stay at Hasbro Children’s Hospital a positive experience for our patients and families. Please allow four weeks for processing and review of your application.

For more information, contact Child Life Services at ChildLifeDonations@lifespan.org.

Your Information

Name

First

Last

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone Number

Previous Event Information

Have you done a special event for Hasbro Children’s Hospital in the past?

Please explain:

Do you have a personal connection to Hasbro Children’s Hospital (such as a current or former patient, family member of patient, or family member of an employee)?

Please explain:

Have you performed/visited at other pediatric health care institutions?

Please explain:

Current Event Information

Program Title

Number of people in group (not to exceed 10; all participants must be age 18 or older).

Type of Event

Event description and details

Estimated Duration of Program

Set-up time required

Breakdown time required

Bringing supplies? (You must provide your own.)

What types of supplies?

File Upload

Please feel free to submit a photo, video, and/or audio recording with your application if you believe it would help further describe the entertainment or activity you would like to offer our patients.

Do not upload any files depicting patients or people, other than the entertainer, who were filmed or photographed in a setting that was not public.

One file only.
512 MB limit.
Allowed types: gif, jpg, jpeg, png, mp3, mp4.

References

Please list other places you have performed/visited, a contact person at each site, and a telephone number contact for each.

Additional Requirements

Equipment

Tables

Chairs

Access to an electrical outlet

Other

Please explain

Parking

Date(s) you would like to host the event.

Please note that applications for holiday season events (December) must be received by November first.

Group visits are scheduled Monday through Friday for a duration of one to two hours, typically between the hours of 10 a.m. to 12 p.m. and 1 to 4 p.m. If you have specific time preferences, please indicate below.

Preferred Date

First Alternative Date

Second Alternative Date

Start time

Do you plan to request media coverage?

Is there anything else that you would like us to know regarding your proposed visit?

CAPTCHA