Share Your Story

Know the Glow is a collection of inspiring personal stories from "Glow" families around the world. These stories provide hope and inspiration to families with children fighting Glow-related diseases.

Glow stories submitted below will appear on our Glow Stories page. If you have a powerful story to share, we want to hear from you! Your story can help find children around the world at risk of blinding diseases. Please share your story below.

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Contact Email*
Phone
Did your child ever exhibit the Glow?*
- Yes
- No
Date Diagnosed
MM slash DD slash YYYY
My child ____________, age ____, has been diagnosed with _____________.*
Age*
Age*
Where was your child treated? (optional)
Treating Physician (optional)
Please give us a brief synopsis of your story*
Upload an Image
Must be JPG or PNG and include the person the story is about.
Drop files here or

Accepted file types: jpg, png, Max. file size: 50 MB, Max. files: 1.
OPTIONAL: After hitting submit you will be taken to the Waiver and Release form. At your discretion, please fill it out and sign it. Thanks!
Comments
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