TO nominate a Stage 4 Breast Cancer candidate for a 2024 RETREAT4STAGE4 vacation experience, read the important information below before submitting your nomination. Nominations close on April 15, 2024.

The 2024 Honoree names ARE posted on this page JUNE 1, 2024.

Our RETREAT4STAGE4 vacations away from cancer accommodate between 4 to 6 family members. The nominee must be a legal resident of the fifty (50) United States or the District of Columbia and have reached the age of majority in the Nominee’s state of residence at the time of entry. Transportation and Meals are not included. LESLIE'S WEEK pays for the Accommodations, the Welcome Reception, the BBQ & Music Family Day, the CIRCLE4STAGE4, the HANDS4GIVERS, the CLUB4KIDS events, the DREAMS4TEENS program, and the Gift Bags for our Stage 4 MBC women.

We will select 25 Stage 4 Breast Cancer women & their families for our 2024 RETREAT4STAGE4. LESLIE’S WEEK hosts this at the Dollywood DreamMore Resort in the Tennessee Smoky Mountains, on Sunday, July 28 check-in and Friday, August 2, 2024 check-out. The LESLIE'S WEEK Breakfast Welcome Reception is at the Ridge Event Center on Monday, July 29 from 9:00 AM to 11:30 AM. From 1:00 to 5;00 we host the CIRCLE4STAGE4 for our women, the HANDS4GIVERS for our husbands/partners, the CLUB4KIDS for the small children, and the DREAMS4TEENS. Our family programs include lunch appetizers and beverages. These events are exclusively for our families to Meet & Greet, form bonds, share their stories, network, and create a community of engagement with their new friends for the week's events.

The Family Day BBQ is hosted under the DreamMore tent on the Meadow Event Lawn on Wednesday, July 31, 2024. Our DJ Frank hosts a karaoke event for the kids and adults — IT IS THE MOST FUN!

This week is for the family to spend time together and enjoy their retreat vacation away from cancer.

NOMINATION FORM for Stage 4 Breast Cancer Women

ALL INFORMATION ON THE FORM MUST BE COMPLETE TO BE ACCEPTED

Nominee's Name

PLEASE BE SURE TO COMPLETE ALL INFORMATION IN EACH BLOCK OR THE NOMINATION WILL BE CONSIDERED VOID.

First Name

Last Name

Nominee's Age

Nominee's Address:

NOMINEE'S CITY OF RESIDENCE

NOMINEE'S STATE AND ZIP CODE

Nominee's Phone Number

Nominee's Email

Nominee's Children NAMES and AGES

NAMES, AGES, RELATIONSHIP of IMMEDIATE Family Members Attending with the Nominee.

Only family members related to the nominee may attend, i.e. husband, children.

TOTAL NUMBER OF FAMILY MEMBERS ATTENDING WITH NOMINEE

Your Name and Your Phone Number

Your Email Address

Nominee's Date of Diagnosis

Nominee's Body Metastasis, PLEASE BE SPECIFIC

Nominee's Doctor's Name

Nominee's Doctor's Phone Number

Nominee's Doctor's Email

Nominee's Cancer Center/Hospital Phone Number

Reason for Nomination

Please describe any physical limitations. This does not influence selection.

Let us know if special needs are required for her comfort, i.e., wheelchair, room location, food allergies, etc.

NOMINATIONS

TO nominate a Stage 4 Breast Cancer candidate for a 2024 RETREAT4STAGE4 vacation experience, read the important information below before submitting your nomination. Nominations close on April 15, 2024.

The 2024 Honoree names ARE posted on this page JUNE 1, 2024.

NOMINATION FORM for Stage 4 Breast Cancer Women

ALL INFORMATION ON THE FORM MUST BE COMPLETE TO BE ACCEPTED

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