(Unfortunatly, this form cannot be filled out here, but this form can be copied, simply highlight the text and hit Ctrl/C, then go into a document and do Ctrl/V). 

 

    All of our children’s names that were one the benches are now on the two bridges in Vilas Park. This form is to request any new names to be added. This information will also be added to our database, to receive our newsletter and other information. Please print or type the following information. Child’s Name (only first & middle names on the plaque) First Name________________________ Middle Name ______________________ Last Name _________________________ Birthdate ___________________ Deathdate ______________________

Parent name (s) Mother _________________________ Father _______________________

Stepparents (if applicable) _________________________________

Address ____________________________________________________

Phone Number ____________________ Email ____________________