Apply

Consent*

I have read and understand the application requirements and qualify to submit an application.

We will reply to you within 3-4 weeks after you have applied ONLY IF WE ARE ABLE TO PROVIDE AN OWLET TO YOU.

If you do NOT hear from us within this timeframe, unfortunately we are unable to provide one to you.

Butterflies and Birdies Foundation is a non-profit organization that donates Owlet Socks to families who have been directly or indirectly affected by the loss of a child. We wish we could provide an Owlet to every applicant, however, because we rely solely on donations, we unfortunately are not able to do so. (This is the hard part for us….)

PLEASE APPLY ONLY IF YOU HAVE MEET REQUIREMENTS BELOW:

1) You agree to utilize this device as it is intended.

2) Your baby is 3 months old or younger. We want to make sure babies are receiving maximum amount of time to use their Owlet.

3) If you are currently pregnant and your due date is within the next month. Please apply when you are within one month from your due date. We do not send Owlets out until the baby has arrived.

****THE OWLET SOCK IS TO BE USED IN ADDITION TO SAFE SLEEP PRACTICES. IT IS NOT A REPLACEMENT FOR SAFE SLEEP!!!****

Your Name*

First Last

Your Email*

Who are you applying for*

Shipping Info

Recipient Name*

First Last

Recipient Address*

Street Address Address Line 2 City State ZIP Code

Infants date of birth or Mother's due date:*

Does the baby have any known health issues? If so, please explain.

Have you ever had miscarriage, stillbirth or lost an infant to SIDS or another health condition?*

Yes
No

Hospital Offered a CuddleCot?

Yes
No

Only answer if your baby was Stillborn. Did the hospital offer you a CuddleCot™ for your baby while you were in the hospital? (A CuddleCot™ is a cooling pad placed inside a portable Moses basket. The cooling system helps to preserve a stillborn so families have more time to say goodbye to their baby.)

How many children are currently in the household?*

How did you hear about Butterflies and Birdies Foundation?*

Tell us your story (minimum of 300 words)*

Terms and Conditions*

I have read the terms and conditions and agree to them.

By submitting this application, you agree this information is honest and accurate.

If you become an Owlet Sock recipient through the Butterflies and Birdies Foundation you are agreeing to the following:
Allow Butterflies and Birdies Foundation to share your story.
Send us a photo of your baby wearing the Owlet Sock so that we can use it on our social media, website and for other media purposes such as news stories and promotional videos. (Last names and addresses will not be disclosed.)
Not sell the product at any time.
Take care of the product so that it remains in like-new or gently-used condition and will pass it along to another family when you have completed using it.

Butterflies and Birdies Foundation and Owlet are not responsible for diagnosing infant illnesses nor does the Owlet prevent SIDS from occurring.

References or proof of information may be required for approval.

Owlet Dream Sock

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