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Sajni Center Code Request

Sajni Center Programs Code Request

Programs at The Sajni Center are open to families, regardless of income, who have children from birth to age 21 who have a life-threatening illness (see list of 200+ qualifying illnesses here). Bereaved families who lost a child/sibling to life-threatening illness are also invited to all programs, and bereavement-focused programs are offered as well. 

For more information about these programs, please click here

If you are a parent/caregiver of a child with a life-threatening illness (or age 18+ applying for yourself), please complete the form below to receive the code to view and register for events at The Sajni Center

If you would like to refer a family for programs but are not the parent/caregiver/adult patient, please click here.

Code Request Form
Name of child with cancer or life-threatening illness
Child's DOB
Child's preferred pronouns
City and State of Residence
Child's diagnosis
Date of diagnosis
Main hospital of treatment
Oncologist/primary doctor's name and email/phone number
Social worker name and email/phone number
Your name
First Name
Last Name
Your cell phone number
Would you like to join our text group to receive notice of upcoming Sajni Center events?
Names and ages of other children
How did you hear about Lucy's Love Bus/The Sajni Center?
What programs are you interested in attending?
What other types of programs would you/your children be interested in attending?
By submitting this form, I agree that all the above information is true. The code sent to me will only be used by the family of a child with cancer, life-threatening illness, or chronic medical condition to register for The Sajni Center programs/workshops.
By submitting this form and attending a program held by Lucy's Love Bus, I release Lucy's Love Bus and associated practitioners from all liability, costs, and damages, which could arise from participation in the above an event or activity.

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