Costume Care Packages – Chelsea Hicks Foundation

Costume Care Packages are an extension of our Chelsea’s Closet inpatient costume play therapy program. Serving children with serious illnesses and extended hospital stays. We aim to brighten their days and give them an opportunity to Dance like Princesses and Fly like Superheroes.

Upon completion of this form, you should receive an email confirmation that we have received your request. If you do not, please check your spam folder. If nothing within 48 hours, please call us at (503) 941-5229.

Request a Costume Care Package

Child's Name*
First Last
Child's Age*
Parent/Guardian Name*
First Last
Parent/Guardian Phone*
Parent/Guardian Email*
Child's Hospital*
Reason for Hospitalization*
Hospital Check-In*
Child's Address*
Street Address Address Line 2 City State ZIP Code
Costume Preferences
Please select the Top Three (3) Themes that your child would like. Specific character requests can be listed in the Sub-Category box (for examples, please click here).
Costume Category 1*
Costume Sub-Category 1*

For examples, please click here.
Costume Size 1*
Costume Category 2
Costume Sub-Category 2

For examples, please click here.
Costume Size 2
Costume Category 3
Costume Sub-Category 3

For examples, please click here.
Costume Size 3
Additional Notes
Are their siblings? Specific character request, Special Needs.
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Request a Costume Care Package

Costume Preferences

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