Interdenominational Infant Memorial Service Registration


7pm, May 11th, 2019

St. Leo the Great Catholic Church


Fill out the form below to register.  There is no cost to attend.  Note: Persons at different addresses should register separately. Households can register together.


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You and the Baby's Name for listing in the program and stating during the service (ex: Chaney Mullins honors her brother Sam Mullins; Mark and Liza Trillino honor their children Jacob, Jack, and Betsy Trillino)
Text to appear on a certificate(s) of life that acknowledging the baby's human dignity: (ex: Chaney Mullins, honors Sam Mullins, my brother lost to miscarriage; In honor of the life of my grandchild Baby Jones, child of Betsy Jones.) Please feel free to request individual certificates for each child.
Church / Parish
Any special requests? (such as reception dietary restrictions; if you would like to be called up at the same time as your friend attending the service)
State / Province*
Confirm Email*
Additional Comments

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