We will only call you if we have a question about the spelling or representation of your baby or child's nickname

This will allow us to report on actual attendance numbers

Name or nickname as you would like it to appear during the service. If you are remembering more than one baby or child who have the same remembrance date, please separate their names with a comma.

If you are remembering more than one loss please fill in here.

Thank you

If you have more than three losses or issues filling out the form please contact communityengagement@rednose.org.au

We look forward to remembering your babies and children at this special service.