Design a Bead with Beads of Courage & United Therapeutics 2025

Honoring the courage and providing encouragement for children and teens coping with neuroblastoma.
Bead Design Challenge 2025

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Parent/Guardian Name Parent/Guardian Name First Last
Parent/Guardian Email (unless BOC member 18+)
Parent/Guardian Phone: Parent/Guardian Phone: - ### - ### ####
BOC Member's Name: BOC Member's Name: First Last
Tell us more about you:

Tell us more about you: child or teen coping with neuroblastoma diagnosis sibling of child/teen coping with neuroblastoma diagnosis clinican who cares for a chlid/teen with neuroblastoma diagnosis Other Other
If you already receive Beads of Courage, where do you receive your beads?
If you don't already receive Beads of Courage, would you like to?

If you don't already receive Beads of Courage, would you like to? I already receive BOC Yes, I would like to receive Beads of Courage I am not sure and would like to learn more about Beads of Courage I am not interested at this time Other Other
Mailing Address if bead design is chosen: Mailing Address if bead design is chosen:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Do you have a picture of your design? Upload it here to share with our judges!

Attach Files
Describe your Bead Design. What shape is it? What color(s) is it? Does it have patterns? What does it feel like? Describe in as much detail as you can.
Optional for BOC members - What do you love about your Beads of Courage collection? How has having BOC helped you? We love to hear your feedback!
I hereby give Beads of Courage, Inc. & United Therapeutics permission to use these photo (s) and content I have provided, in perpetuity, for any purpose related to this Beads of Courage contest, and any other reason deemed appropriate by Beads of Courage, Inc., including but not limited to: print materials; newsletters; signage; on the Beads of Courage website and social media accounts; for media coverage (television, blogs, newspaper, magazine, ezine, ebook, etc.); for educational purposes; for publicity benefiting Beads of Courage, Inc, a non-profit organization.

I hereby give Beads of Courage, Inc. & United Therapeutics permission to use these photo (s) and content I have provided, in perpetuity, for any purpose related to this Beads of Courage contest, and any other reason deemed appropriate by Beads of Courage, Inc., including but not limited to: print materials; newsletters; signage; on the Beads of Courage website and social media accounts; for media coverage (television, blogs, newspaper, magazine, ezine, ebook, etc.); for educational purposes; for publicity benefiting Beads of Courage, Inc, a non-profit organization. Yes-I provide the permission described above No-I do not provide this permission described above
My signature below agrees that I will release Beads of Courage, Inc. and United Therapeutics and their employees, volunteers, and agents from all liability related to the creation and distribution of the Neuroblastoma Bead.

I am also aware of the safety guidelines related to beads and any Beads of Courage materials:
Beads of Courage, Inc. as provided safety guidelines to the artists to prevent sharp edges. Please be aware that beads could be a choking hazard and dangerous if broken. Please discontinue use and do not handle if broken. Please do not leave the bead or any items from Beads of Courage, Inc. unsupervised with anyone who puts items in their mouth.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date of form completion Date of form completion / MM / DD YYYY

Design a Bead with Beads of Courage & United Therapeutics 2025

Design a Bead with Beads of Courage & United Therapeutics 2025

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