A Time to Remember Memorial Service RSVP

A Time to Remember Memorial Service RSVP

Please RSVP by April 15, 2025

If you have any questions, please contact remember@childrens.harvard.edu or call 617-355-3195.

Full name of the person you are remembering*

Your first name*

Your last name*

Address

Please add your mailing address here so we can confirm that we have your correct information for occasional bereavement correspondence.

Your Street Address:*

Street/Road/etc. here only

City/Town*

State*

Select from dropdown list

Select

Mailing Zipcode*

Your phone number*

Phone

Your email address*

By signing up for this event, you will receive occasional emails from Boston Children's Hospital's Bereavement Program to learn about upcoming events and programming.

Total number of family members who will attend*

Select or enter value

Please list names of any staff member(s) you would like us to notify about your plan to attend:

PHOTO RELEASE

If you plan to submit a photo for the photo slideshow, please complete the required authorization for use and release of information and images

Please make sure to list the expiration date as a date AFTER 05/02/2025

https://na3.docusign.net/Member/PowerFormSigning.aspx?PowerFormId=d0e7e50e-5731-4f97-a053-5a55846df6bf&env=na3&acct=dae68941-4bfa-4cdd-b9a1-e3b56ea24dc7&v=2,

If you have photos ready for the slideshow, you may attach photos here now:

We can include up to 4 photographs per family. You are welcome to attach individual photos of your child, your family, and any photos with BCH staff. Please submit no more than 4 photos in total.

Drag and drop files here or

If you submit your photos for the slideshow here, you do not need to email the photos separately. You can also RSVP now without attaching photos. Simply complete the photo consent and email your photos separately to: remember@childrens.harvard.edu

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