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A Better Night Sleep - Remote Intake

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2026 Houston Children’s Charity Children’s Bed Application

Note: Participation in this program is limited and will be filled on a first come, first served basis. If your contact information changes (phone number or address), please call our office to update your information.

By submitting this form you also agree to allow pictures of you and/or your children in any HCC publication.

By submitting this form you agree to HCC’s Waiver & Release of Liability, Assumption of Risk, and Indemnity Agreement located on houstonchildrenscharity.org/waiver/

INCOMPLETE and Walk-in applications WILL NOT be accepted.

Houston Children’s Charity • 1600 West Loop South, Suite 610 Houston TX 77027 • Phone (713)524-2878





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Questions? Contact A Better Night Sleep - Remote Intake for support.
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