Get ready to apply
Just In Power Kids
Relief & Restore
What you get
Help with adaptive equipment, approved camps, lessons, or tickets, arts supplies or instruments and durable medical equipment. The amount isn't published. Ask. Ask whether requests are open.
- Who starts it
- You, with a document from your social worker or doctor
- How it’s sent
- Email to bethanyjipk@gmail.com, or by post
- Your time
- About 15 minutes, plus waiting for the document
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Your child is 17 or under.
- Expenses require program review; supplements and holistic care also need medical-team approval.
- Grant count and annual funding are limited.
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Ask your social worker or doctor for the documentStart here. This is the part that takes the longest.
Just In Power Kids needs a signed confirmation of the diagnosis from your social worker or doctor. Copy this message, or say it in person at the next visit.
Hi [social worker’s name], We’d like to apply to Just In Power Kids’s Relief & Restore. They offer help with adaptive equipment, approved camps, lessons, or tickets, arts supplies or instruments and durable medical equipment, and we are checking whether they are taking requests. They need a signed confirmation of the diagnosis from you or someone on the care team. Their form and instructions are here: https://justinpowerkids.org/programs Could you do that when you have a chance? I’ll bring the printed form to our next visit, or I can email it. Thank you for everything you do for us. [your name] · [phone]
Copying is the only thing this page does with your text. Nothing is saved. -
Fill in their formPrint it, or fill it in on screen if the PDF allows.
Open the application PDF ↗ Checked Aug 27, 2026What the form asks for
Parent/guardian and patient needsChild’s NameChild’s Email (if applicable), Date of Birth, Gender, and Mailing AddressCaringbridge/social media pages (we love to follow the child’s journey)Child’s Favorites (hobbies, activities, sports, colors, food, tv show, movie, characters, animals, toys, anything else)Child’s siblings names, genders, and agesParent/Legal Guardian name, phone, and email (two contact blocks)Relief & Restore - financial reimbursement for durable medical equipment, services, and supplies that insurance does not coverMedical assessment · your care team fills this inHospital NameHealthcare professional name and title, email address, and phone numberType of Cancer and Date of DiagnosisIs the child currently undergoing treatment? If not, last day of treatmentI verify that this patient is in treatment or has been treated: (Healthcare professional signature & date)Liability and publicity authorizationI grant / I deny permission for use of my child’s name and imageIf child has two parents or legal guardians, both must sign belowHave ready
- Completed 2025 program application with Healthy Meals selected.
- Receipts for approved services or supplies.
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Email your application and the document togetherTo bethanyjipk@gmail.com. Or post it to the address on the form.
- Email the completed signed application to bethanyjipk@gmail.com or mail it to 1100 Business Pkwy S Unit 4, Westminster, MD 21157.
Email: bethanyjipk@gmail.com
Subject: Relief & Restore application, [child’s name] Hello, Attached are our completed application and the document from [social worker’s name] at [hospital]. Please let me know that it arrived and if anything is missing. Thank you, [your name] · [phone]
After you send
Expect an email or phone call from the Program Director; contact Bethany if no acknowledgement arrives.
