Gabriel's Garden Flower Request
Please read each question carefully and double check that you have answered all applicable questions and that your answers are correct.
REQUEST FOR ONLY ONE CHILD
Your Child's Name
(As you would like it written)
Your answer
Your Child's Birth Date
Your answer
Your Child's Date of Death if different from Date of Birth
Your answer
Your Child's Age or Gestational Age
(You may request a flower for a baby of any GA, and any child under 21.)
Your answer
Your Child's Gender
Would you like a specific type of flower?
We will do our best to honor special requests however we cannot predict which flowers will be in bloom at the time your child's flower is picked.
Special Message or Quote to be Embedded in your Photograph (optional)
(Please choose from the list below or enter your own below)
Special Message or Quote to be Embedded in your Photograph
(If quoting someone else, please include the author's name)
Your answer
REQUEST FOR 2 OR MORE CHILDREN
Your Children's Names AND Birth/Death Dates
ex: Jonathan 7/1/10-7/6/10 and Elena 8/10/12
Your answer
Your Children's Genders
Which would you prefer?
Would you like your children's flowers to be photographed together or separately?
Would you like a specific type of flower?
We will do our best to honor special requests however we cannot predict which flowers will be in bloom at the time your child's flower is picked.
Special Message or Quote to be Embedded in your Photograph (optional)
(Please choose from the list below or enter your own below)
Special Message or Quote to be Embedded in your Photograph
(If quoting someone else, please include the author's name)
Your answer
ADDITIONAL INFORMATION NEEDED FOR ALL REQUESTS
Your First Name *
Your answer
Email Address *
(Your email address will remain private)
Your answer
Blog Address (optional)
(If entered, your blog address will be visible on Gabriel's Garden blog page)
Your answer
Do you have any special requests or comments?
Your answer
Would your like your baby automatically added to the Angel Birthday list? *
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