Morgan’s Legacy Gift Liability and Publicity Release Form

Required when approved for a gift. Allows for required uploads for proof of income and any denial letters from insurance.

"*" indicates required fields

Congratulations on being selected as a recipient in our Morgan’s Legacy Gift Program!

We are so pleased that your child has been selected to receive this gift!

We will be placing the order as soon as this completed form with all required documentation is received in our offices, please allow up to 14 days for processing.

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Name*
Child's full name
Email*
Parent's email address
Gift Requested*
Category applied for

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The following documentation is REQUIRED to make a final approval decision for your Morgan’s Legacy Gift request.

Please upload tax return(s) for 2022 for each earner in the household.
Drop files here or
Accepted file types: doc, docx, pages, pdf, Max. file size: 300 MB.
    Please upload denial letters from all insurances, Medicare and Medicaid if applicable. In the alternative, please upload documentation that this is not a covered item by insurance. If no proof is being submitted, please upload a statement detailing why.
    Drop files here or
    Accepted file types: doc, docx, pages, pdf, Max. file size: 300 MB.

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      This Release is mandatory to be able to confirm your approval for a Morgan’s Legacy Gift.

      Please use a mouse or stylus to add your signature to this mandatory field.
      Clear Signature
      If you are open to us tagging you in our social media announcement of the Morgan’s Legacy Gift recipients please provide your information for Facebook, Instagram and Twitter
      Select date MM slash DD slash YYYY
      This field is for validation purposes and should be left unchanged.