Apply as a Family

Team IMPACT provides children with serious illness and disability the opportunity to experience positive social-emotional development through the support of a team.

Complete this form and a member of our staff will reach out to you to schedule an introductory call and complete the application process.



    Parent/Guardian #2

    Home Address

    Family Details

    Family Race / Ethnicity

    Your answers to questions related to race/ethnicity and family income will not be shared with anyone and will have no bearing on your eligibility or participation in Team IMPACT. We collect this information in order to better analyze our program as a whole and to ensure we’re delivering a high-quality experience for families of every background, identity and income level.
    If you do not receive a confirmation email immediately after submission please check your spam folder or send an email to

    Who We Work With

    The Kids

    Helping kids experience life beyond serious illness and disability.

    Eligibility Requirements:

    • Children ages 5-16
    • Diagnosed with a serious or chronic illness
    • Require ongoing treatment and/or extended hospital stays
    • Could benefit, both socially and psychologically, from the support of a team
    • More than 1/3 have been diagnosed with cancer; other common diagnoses include cystic fibrosis, cerebral palsy and muscular dystrophy