2011 Gift Exchange
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Your Name
Your email address *
Your mailing address *
Your City *
Your state/province *
Your zip code or postal code *
Country *
If you are the sibling of a baby that has passed away, how old are you?
What is your relationship to the baby(ies) that have passed away? Mom, Dad or sibling?   *
How many babies have you lost? *
What are your baby(ies) names and dates of birth/loss? *
For example: Jacob, lost at 21 weeks on June 1, 2010
Tell us briefly about your loss/story
What special things remind you of your child(ren)?
For example: butterflies, trees, bears, angels, stars
D
選択を解除
Do you have a blog? If so, please share the address!
Are you willing to send an additional gift to someone whose first match backs out?
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