2017 HAND Service of Remembrance Response Form
Please complete by September 8th.
What is your first and last name?
What is your phone number should we need to contact you prior to the event?
Please write in the box below the name(s) of the baby or babies you would like included in our program booklet, which will be read aloud during the service. Nicknames are welcome.
I.e. Cayden Hirsch; Seamus Daley; Baby Smith; Ladybug
If you listed more than one baby's name, please please indicate if twins, siblings or other relation.
Our program booklet will list babies' names alphabetically by last name. Twins will be listed together (Amber Lynn and Alice Marie Johnson) unless parents prefer them to be listed separately (Amber Lynn Johnson, Alice Marie Johnson).
Please provide the phonetic pronunciation of your baby's or babies' names (if necessary). See examples.
(Kay-den Hersh); (Shay-mus Day-lee)
Do you plan on attending the Service of Remembrance on Sunday, October 8, 2017?
How many adults will be attending?
5 or more
How many children will be attending?
5 or more
Would you like to submit a reading, poem, drawing, high resolution photo or other content for the program? If so, please upload the files here.
We will do our best to include your submissions, if space allows.
If you submitted a photo or drawing, how would you like it captioned? Suggested format: Baby's name, date of birth/death, quote, parents/siblings names.
Example: James Anthony Smith, September 10, 2005, "Forever in our hearts." From Susan and John Smith (or Love, Mommy and Daddy)
If submitting a poem or reading, please provide title, author, and name of person/s submitting it.
Are you interested in reading aloud at the Service of Remembrance?
Would you like to contribute drinks or light snacks for this event? If yes, please sign up here:
Questions? Concerns? Please send an email to
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