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Nominate a child for a Wish Day

In order to nominate someone for a #KeiraStrong Forever Wish Day, the child must meet the qualifications stated in the bylaws of the foundation of being under 18 years of age with a diagnosis of relapsed and/or terminal cancer. Nominee must live or currently being treated locally within 100 miles of St. Louis County. Submission of this form does not automatically guarantee the nominee to be granted a wish day. A HIPAA release of patient information form will automatically be sent to the email below.

Please complete the form below

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Name
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