Make-A-Wish® Northeastern & Central California and Northern Nevada
and The Songs of Love Foundation® Come Together to Bring More Smiles!

The Songs of Love Foundation® is a national nonprofit 501(c)(3) organization that creates free, personalized, original songs to uplift children (ages 1-21) facing tough medical, physical or emotional challenges. Each ‘song of love’ is delivered on USB and/or digital format with professionally produced music and lyrics containing the child’s name and references to all of his or her favorite things. Since 1996 the Songs of Love Foundation® has reached out to over 36,000 children in over 600 hospitals and health care facilities in all 50 states and the world.

Songs of Love® is thrilled to be bringing the Medicine of Music™ to the children of Make-A-Wish® Northeastern & Central California and Northern Nevada in this unprecedented musical collaboration of love!

Child Info

(All fields with an * are required and must be filled in. Please make sure form is completely filled out before submitting it.)

Haga clic aquí para el perfil en Español.

Medical Info

Parent or Guardian Info

Where Should Song Be Sent

(Leave blank if same as parent or guardian address)

Publicity Release

I, the undersigned, hereby grant to Songs of Love Foundaton (Songs of Love) the right, license, and privilege to use my name, likeness, photograph, voice, and biography, as well as the "Song of Love" written for the above-named child in such a manner as Songs of Love shall deem appropriate, (including but not limited to fundraising, etc) in order to promote, advertise, and publicize Songs of Love and its charitable activities.
Click or drag a file to this area to upload.
If possible, PLEASE upload a photo of child. (max file size:10mb)

Also, you can download this form for email, fax, or mail by clicking here.
(Not all Firefox browsers support fillable PDF files. If this is the case download the form, fill it out and email it to: songwriter@songsoflove.org.)