Miscarriage, Infant or Child Loss Memorial Please return this form and join us even if your child was remembered a previous year. Each year's service and momento given will be different! Please duplicate this form for others! For further information, contact Pam Mullins. Parish: 739-0331 ext. 319 Fax: 749-9771 Email: email@example.com Please return this portion by Oct. 26, 2009, to have your child's name included in the Memorial Program. Return to: St. Bernard Church, 1617 W. Pine Street, Appleton, WI 54914 Kno _____I will attend the service on November 1, 2009. I will be bringing ______guests. _____I cannot attend the service, but would like a copy of the program. (You may pick up a copy at the Parish Office anytime after 11/1/09) _____I would like my child(ren)'s name(s) to be included in the service and program. PLEASE PRINT! Child(ren)'s Name(s)_________________________________________________________________ (If you have not named your child, we invite you to do so. Some people call the child “Baby” with last name, such as "Baby Smith".) Your Name____________________________________________________________________ Relationship to child:____________________________________________________________ Address ______________________________________________ Phone _________________ Street state zip Donations for the memorial are appreciated, but not necessary. Sixteenth Annual "Tree of Light - Wreath of Remembrance" Service November 1, 2009 All Saints' Day - 7:00 p.m. St. Bernard Church 1617 W. Pine Street Appleton, Wisconsin 54914 Sponsored by St. Bernard’s, St. Therese’s and St. Mary’s Greenville Elizabeth Ministries. Open to people of all faiths! Perhaps they are not the stars, but rather openings in heaven where the love of our lost ones pours through and shines down upon us to let us know they are happy.
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