Request a Blessing Box

While the majority of our boxes are given through our hospital partners, we are able to ship out a limited quantity of our boxes to families outside of the area we serve. NOTE: Items included will vary.

A donation to assist in covering costs of the box is humbly requested, and allows us to continue to support families outside the network of our hospital partners. Click here to donate in honor of or in memory of a loved one.

In our short two years as a non-profit, we have mailed over 50 boxes to loss families across the United States. If you have a request of a blessing box for a family, please complete the form below.

Box Request Form

Your Name

First Name

Last Name

Your Email Address

Your Phone #

(###)

###

####

Requesting For:

Myself

A Loved One

Name of Box Recipient

Can use a parent's name or a family name (Ex: The Smiths)

First Name

Last Name

Email Address of Recipient

Address of Box Recipient

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Baby or Child Lost

First Name

Last Name

Gender of Baby or Child

Birth Date of Baby or Child

YYYY

Death Date of Baby or Child

YYYY

Gestational Age of Baby or Age of Infant / Child

Our Blessing Boxes are customized based on age and shipping location. *Items in the box may vary*

I follow Ryker's Rainbow on Facebook (@RykersRainbow)

I follow Ryker's Rainbow on Instagram (@RykersRainbow)

How did you hear about Ryker's Rainbow?

Additional Details

Any other information you would like to include:

Our non-profit operates solely on donations. We humbly request a donation to assist in the cost of mailing the box. *NOTE: Mailed boxes will vary from our hospital boxes

Thank you for your consideration of a tax-deductible donation to Ryker's Rainbow easiest made via our website