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Operation North Pole 2017

Operation North Pole 2017
Operation North Pole (“ONP”) encourages Eligible Families who have a child battling a life-threatening/terminal illness to apply to participate in our Fantasy Trip to the North Pole on December 9, 2017. The first 75 families who complete the Invitation to Apply and meet the criteria of our Selection Committee will be notified and offered the opportunity to attend our event.  Please refer to the following guidelines to help you determine if your family is eligible to apply.

  1. Families may only attend Operation North Pole one time, no repeat participation is permitted.
  2. Operation North Pole does not provide transportation to or from the event, this is your responsibility.
  3. The sick child must be 12 years of age or younger at the time of the event.
  4. The illness must be life-threatening/terminal or result in permanent disability.
  5. The sick child must be healthy enough to participate in activities that span up to 10 hours.
  6. ONP requires releases that must be signed by the parent regarding Use of Image and Likeness and a General Hold Harmless.  We cannot make exceptions to this policy.
  7. Families agree to provide hospital and/or physician contact information for verification purposes of information provided.
Please be aware that our event includes therapy dogs and miniature horses as well as loud noises and bright lights.  Our event may not be appropriate for your child if they have certain allergies   or sensitivities.  Food is also served at various times during the day, including breakfast and lunch.  Unfortunately, we do not have the ability to accommodate special dietary needs.  Finally, because our event includes a train ride on the Union Pacific Northwest Line, we have limited space for children requiring use of a motorized wheelchair.  If your child requires use of a wheelchair and you feel your family is otherwise eligible, we encourage you to apply as early as possible.

Please fill out the application on the following pages in its entirety. You will not be able to save and come back to the application, so please make sure you have the following information available to you, before you begin filling out the remaining pages of this form: -The names of all of immediate family members who will be attending the event (immediate family includes parents of the patient, the patient and MINOR siblings) -The names and birth dates of all MINOR siblings who will be attending the event -The names and contact information of your primary care providers including your doctors, Child Life Specialist, Hospital/Clinic Affiliation, including phone numbers and if possible, emails.  A list of any special considerations that anyone in your family may need (i.e. a high chair, wheel chair access, etc) If you have any questions regarding the application before you start it, please do not hesitate to contact us: Operation North Pole (847) 813-5387; or by email at onpchicago@gmail.com 

Thank you.



 

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