Refer A Child for A Wish

Anyone can refer a child to Starlight for a wish – parents, grandparents, medical professionals, friends, social workers… Simply complete the online wish referral form below or download a PDF version, complete and return to us by fax or post.

Whatever the wish, Starlight will make it happenWhatever the wish, Starlight will make it happen

We aim to create a truly magical experience for the child and his or her family, exceeding all expectations and creating precious, unforgettable memories to share, laugh and smile about. We deal with every organisational detail and ensure that no additional burden is placed on parents

Who is eligible?

Starlight grants wishes for children who are:

  1. 4 -18 years old (inclusive)
  2. Suffering from a life-threatening illness or life-shortening illness
  3. Able to choose and communicate (verbally or non-verbally) their greatest wish for themselves
  4. UK residents

N.B. If the child has already had a wish granted (by another organisation), they are sadly not eligible.

If you are in doubt, please call 020 7262 2881 and press 1 for our wish granting team.

Child's Details

Child's First Name *

Child's Last Name *

Child's Gender *
 Male Female

Child's Date of Birth *
/ /

Condition

Condition or illness wish child suffers from

Hospital / Hospice Details

Name of hospital or hospice attended by wish child

Parent / Legal Guardian Details

 

Title *

First Name *

Last Name *

Address *

Address

Town *

County

Postcode *

Country *

Email *

Phone Number *
Area Code Number

Referrer Details

If not Parent or Legal Guardian

Title

First Name

Last Name

Address

Address

Town

County

Postcode

Country

Email

Phone Number
Area Code Number

Found Us?

How did you hear about Starlight? *

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