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Quilts for Children
Newly Diagnosed with Diabetes Information about the child you wish to receive a Comfort Quilt
Information about person requesting quilt
Biographical Information Please attach a brief letter telling us about your child. We reserve the right to post any information you provide (except specifically identifying information) on our website or in publications and mailings for the purpose of letting others know about our good works. If you do not share something about your child we reserve the right to refuse your request. You may also send us photos via mail or e-mail. A picture of your child to go along with their personal story really helps us to raise awareness as well as donations for this program. (This mandatory biography helps us curtail fraudulent requests.) Terms and Conditions for Requesting A Comfort Quilt I, ____________________________________ (print your name) am requesting a free comfort quilt for a child who has been clinically diagnosed with some form of diabetes. I promise that I will not resell, give away to anyone other than the child named in this request, or otherwise seek to benefit financially in any way from the request and receipt of a comfort quilt from IPump.org, Inc. I release and hold harmless (i.e., I will not sue, file complaints, seek damages against, or take any legal action against) IPump.org, Inc. and/or any and all of its officers, board members, volunteers, staff, or donors, from any and all liability, injury, and/or damages that may arise from receiving or using anything, including a quilt, from or through IPump.org, Inc. I understand that any quilt sent to me has been donated to, or made from materials donated to, IPump.org, Inc. by other businesses or individuals. All quilts sent are not used and have been newly made by volunteers. I agree to accept “as is” any quilt sent to me by IPump.org, Inc. I understand and agree that user fees and/or donations are non-refundable. I understand that I may return the quilt to IPump.org, Inc. if I do not wish to receive it but that there are no refunds or exchanges. If there is reasonable cause to exchange a quilt, and IPump.org, Inc. should so choose to exchange a quilt, I may be required to pay for shipping costs for a replacement quilt. ________________________________ ______________ User Fee (Shipping and Handling Costs). Last year our cost to ship quilts exceeded $1,000 -- enough to have recertified 5 insulin pumps. We hoped voluntary donations would cover the costs of this program but only 4 people out of 60 who ordered quilts made donations to cover their own shipping costs. Therefore, as of 01/01/2008 we now find it necessary to charge a user fee of $12.00 per quilt. This user fee is intended to help cover the cost of shipping and handling (postage and the large envelopes at $1.79 each) and not to make money off the quilts.
We apologize for having to switch from a program we intended to provide entirely for free but our total financial donations for 2007 (from outside sources) were less than $350. Our Board has personally been paying for all our business and program expenses and as much as we would like to keep paying for the shipping of quilts, we are simply unable to do so. User fees can be made via our PayPal button on our website or by mailing a check made payable to IPump.org. Please do NOT send cash. Mail this entire request form, user fee of $12.00, and any attachments to: IPump.org,
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