Poncho Request for Individual Child

Please complete the requested information for a poncho for a child in your care. For other inquiries, please use the Contact button in the footer of our webpages.

This form is to request a poncho for a child in your care. If this is for a relative or a gift, please visit our shop.
Please double check that you have typed the email address correctly so that we can reach you.
Cape Ivy ponchos are designed to work with IV lines and ports and are given to children in medical treatment for chronic or critical illnesses.
We will ship the poncho to the facility where your child receives treatment, if allowed by the facility.
Please provide contact information so that we can make arrangements to ship a box of ponchos including one for you child.
Please provide age and gender of your child, along with interests and/or likes or a specific print you have seen on our webpage or social media pages. The sizes are toddler, child (approximately ages 5-12), and teen.