Dream Referrals
Please fill out the form below if you are between the ages of 15-25 or if you would like to refer a dream on behalf of the foster youth in that age range. Referrals will be considered regarding help with education, career goals, independent living, and/or constructive hobbies or talents.

Top 3 Dream Ideas

In the spaces below, please list the TOP THREE Dream ideas in just a few sentences

Youth Information

Did the youth age out of foster care without adoption, kinship placement, or being reunified with family? *
Has this youth received a dream through dream makers? *
Would You Like to Add a Photo of You? *

Photo & General Media Release

I, the undersigned, hereby authorize Dream Makers - a program of America’s Kids Belong to use my submitted words and media. I authorize the use of any such printed, photographic, or electronic reproductions for any purpose, including, but not limited to educational and promotional media as may be deemed appropriate by Dream Makers - a program of America’s Kids Belong.

Agreed & Accepted By:

I am signing this form as an Individual *
I am signing this form as a representative of a group, and have full authority to grant release for this group
Upload Your Photo *
Maximum upload size: 2MB
Are You - or the Above Mentioned - an Adult or a Minor? *


I certify that I am the guardian/social worker/foster parent/other of the individual above,

a minor under the age of eighteen years.

I hereby agree to assume legal responsibility for his/her authorizations referred to in this General Media Release.

Typing your name here and submitting this form serves as a Legal Signing of this Document.
Is You Address Different from the Above? *

*Disclaimer: Dream Makers reserves the right to refuse dreams based on liability or improbability of fulfillment*

America's Kids Belong

Dream Makers is a program out of America's Kids Belong. America's Kids Belong is a 501(c)(3) non-profit


America's Kids Belong 1540 Main St. Unit 218 #331 Windsor CO 80550

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