Olivia's Big Splash Custom Bath Giveaway Entry

Your nomination package must include the nomination form with one photo of the child (jpg), two photos of the bathroom to be remodeled (jpg).

Olivia's Big Splash is a sponsored charitable benefit to improve the everyday lifestyle needs of families for a child or children with special needs. See Full Entry Rules and Eligibility Here.

One entry per child, please.

Company

This field is for validation purposes and should be left unchanged.

This form may either be submitted by a “NOMINATOR” - a professional in the field of children’sservices (teacher, physical therapist, social worker, etc.) or by a parent or guardian of the child. If submitted by a parent/guardian, a professional in the field of children’s services must be listed as a reference. The nominee must reside in one of the following counties: Jackson, Clay, Cass, or Platte in Missouri, and Wyandotte or Johnson in Kansas.

Nominee Information

The deadline for nominations is October 30th, 2026. Only one entry per child, please.

Nominee's Name(Required)

First Last

Nominee's Date of Birth(Required)

Address of home to be remodeled(Required)

The nominee must reside in one of the following counties: Jackson, Clay, Cass, or Platte in Missouri, and Wyandotte or Johnson in Kansas.

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

Parent/Guardian Information

Parent/Guardian Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Reference or Nominator Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Place of employment

Professional relationship to the child

Nominee's Story

Please provide us with information about the nominee’s situation and how changes to their bathroom will help them by answering the following questions:

Tell us a little about the nominee(Required)

(challenges they face, history, favorite things, etc.)

What is the one item that, if replaced, will make the biggest difference in your bathroom?(Required)

In other words, what is the one thing you need to change most?

How would changes to your bathroom give your child more independence now and in thefuture?(Required)

How do you expect your child’s needs to change in coming years?(Required)

How will improvements to your bathroom make a difference for your child’s main caregiver? How will the improvements impact the rest of your family?(Required)

Qualifying questions

The following questions must be answered for us to consider the entry. We need this information to apply for building permits.

Do you own your home?(Required)

Yes

No

If you have a mortgage, is it current?(Required)

Yes

No

Are your real estate taxes current?(Required)

Yes

No

Photos

Please attach the following images:

One photo of the child being nominated(Required)

Max. file size: 2 GB.

Two photos of the bathroom to be remodeled(Required)

Drop files here or Select files

Max. file size: 2 GB.

All items must be included for nominee to be considered

Submit

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