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For the Families

Those Needing Help

We’re glad you are taking this important step to find help. While you might feel embarrassed to ask for assistance, please understand that you are not alone. Riley’s Army was created to extend a hand to children and their families in need. We hope you’ll take it.

Please complete and submit the form below. Fields marked with * are required. You can also contact us at or see our contact us page for additional ways to reach us.

  • Parent(s) Name

  • Address

  • Contact Information

  • Please enter your date(s) of birth. Your year of birth is of course optional.
  • Child's Information

    Please provide your child's name, date of birth, diagnosis and date of diagnosis. Please provide any additional information or special interests you feel would help us get to know your child.
  • Siblings

    We know the challenges that the entire family faces your child receives treatment. We want to include the whole family in our efforts to help during and after treatment. Please list siblings and their dates of birth. Also list special interests of the siblings.
  • Possible Areas of Help

    Riley's Army wants to help you in any way you need. Some possible areas of help can include prayers, parking passes for hospital stays, dinners, baby sitting for siblings during treatment or watch the kids when you need a break at home. Ask and we will try to help.

    We can also organize your group of volunteers to help save you time and energy. If we can't help, we will try to find services or support that can fill your need.
  • Special Precauation

    Please list any special precautions we should know about your family such as food allergies.
  • Registration Agreement

    All information provided is for Riley's Army use only. I voluntarily accept help and support from Riley's Army. I am under no obligation to accept services and can decline services at any time. I understand services are provided free of charge and no promise of services or financial support has been made by Riley's Army. I understand services are provided by volunteers and understand the limitations of such services. I agree to provide feedback and report any concerns with services provided by Riley's Army to Riley's Army. I understand Riley's Army reserves the right to decline to provide services at any time. Riley's Army does not discriminate based on race, gender, religion or financial status.
  • This field is for validation purposes and should be left unchanged.