(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 on the benches are now on the one of 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.

 

 

First Name________________________

Middle Name ____________________Last Name _________________________

Birthdate ___________________ Deathdate ______________________

 

Parent name (s)

 

Mother _________________________ Father _______________________

Stepparents (if applicable) _________________________________

Address ____________________________________________________

Phone Number ____________________ Email ____________________