Calendar Form

Want to participate in our 2022 photo calendar? Fill out the form below and include a photo of your heart child! The deadline is November 10th, 2021.

Submit a picture

I understand and accept that in order to participate in the 2022 Little Hearts Photo Calendar I have to purchase at least one (1) calendar of my own after submitting this form, if I do not order a calendar by the deadline of November 10th I will not to be able to participate.

I understand and accept that in order to participate in the 2022 Little Hearts Photo Calendar I have to be a member of Little Hearts, if I am not a member I must complete a membership form before the deadline of November 10th or I will not be able to participate.

I understand and accept that my child's name, date of birth, diagnosis and photo will be used in the 2022 Little Hearts Photo Calendar and may also appear on the Little Hearts Facebook Page, Instagram Page, Email Campaign, and/or the Little Hearts website (littlehearts.org) for promotional purposes.