Refer a Buddy Today

“Building Strength in Numbers”

Muddy’s Buddies is always looking to support children battling cancer and other chronic illness in the greater Rochester, NY area. If you know of a child in need of support, friendship and/or a mentoring relationship within their community, let us know. We can pair the child with a high school or college sports team, club, theater group, band or classroom in their area. Muddy’s Buddies also provides those same supports to siblings and the bereaved siblings of children that have passed. Refer a child today!

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Referred Child's Name*
First Last
Referred Child's Age:*
Referred Child's Parent's Name(s)
First Last
Referred Child's Parent's Name(s)
First Last
Referred Child's Parent Email*
Referred Child's Parent Phone*
Please tell us a little about the child’s medical condition. (With parental permission)
Is the child’s parent aware of this referral?
- Yes
- No
School District Attended by Referred Child:
Sports/Activities Child is interested in (i.e Baseball, Soccer, Theater, Dancing, Band, Art, etc.)
Additional Information: