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Your baby's name . . . * First Last
As you want it read aloud, and to appear on the luminaria. Please include any middle name in the first name field.

If you are remembering more than one baby (for example, twins or siblings), and would like them to be read together, please note that at the end.
Date of birth . . . * MM / DD / YYYY
Date of death . . . MM / DD / YYYY
If it's different from their birthdate.
Any quote or message you would like to include . . .
Maximum Allowed: 200 characters. Currently Used: 0 characters.

To be read along with your child's name.
Your name . . . * First Last
We will read your name as the baby's parent (s) after their name is read. There is a field below to add anyone else who will be attending with you.
Will you be attending the memorial? *
Yes No

You do not need to attend to have your baby remembered!
If yes, who will be attending with you?

These names will be read aloud along with your baby's name, so please include relationship, i.e. Grandmother, Aunt, etc.
Your email address . . . *

So that we may contact you if we have any questions.
Any special notes you have . . .

This is where you can note if you would like this baby remembered with his or her siblings.
How did you hear about Gianna's Light? *

So that we know how Gianna's Light reached you, to be able to use our resources wisely in spreading her message of comfort and hope!
Do Not Fill This Out

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