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!
Phone
This field is for validation purposes and should be left unchanged.