Sunscreen Request Form

The Adolescent and Young Adult (AYA) Program is proud to participate in "Don't let cancer get under your skin." Throughout Des Moines our Adolescents and Young Adults (15-35) participate in outdoor group events. While this could be a high school sporting event, college social event, volunteering opportunities, etc. they may or may not remember that sunscreen is important for safety. Melanoma is currently the second highest cancer for ages 15-29. Many do not know the importance of understanding the facts and protecting their skin early on.

The AYA Program wants to help. We will provide free sunscreen to local outdoor events for AYA's (15-35).

Rules:

AYA Program will need at least one week notice prior to the event
AYA events will be in the Des Moines or surrounding areas.
Recipient will provide at least one photo to AYA email of the sunscreen being used UPHDM_AYA@unitypoint.org
AYA Program will give sunscreen to the AYA event along with a sign discussing sunscreen facts and melanoma risks
AYA Program will need a phone call when event is done to arrange for leftover sunscreen and sign

Event Name Person Requesting Name Event Date Event Time Event Location City State Zip Code Contact Person 1 Phone number Email Contact Person 2PhoneHow many people will need sunscreen? (quantity)