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Pennsylvania Families
Inspire Hope, Honor a Child, Celebrate a Life
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Name
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Your answer
Mailing Address
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Your answer
Email
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Your answer
Significant other, living children names
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Your answer
Baby/child names and special dates
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Your answer
What reminds you of your baby/child
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Your answer
Would you like to receive a card in your baby/child special days?
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Yes
No
Do you want us to honor your baby/child at our remembrance events going forward? ( October 15th candle lighting, hearts release,Etc.)
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No
Yes
Would you like information on our Rock & Walk? It's our signature event. We walk in honor of all the babies gone too soon. Held yearly the 1st Saturday in September. Pine Ridge Park in Blairsville Pa. We are looking into zoom for virtual options for those who don’t live near
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No
Yes
Are you interested in our emotional support groups? Held on Zoom and in person (in person is Latrobe Pa)
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Yes
No
More information requested
Which support groups are you interested in?
Pregnancy, infant, and child loss
Pregnancy and parenting after a loss
Sisters in Loss
Dad’s Division
Grandparents
Siblings Grieve Too
Infertility
Other:
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If interested in Support Groups preferred method of contact?
Text
Email
We have a closed group on Facebook for bereaved parents. Do you want to join?
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Would you like to sign up for our newsletter?
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We host various remembrance events and gatherings during the year. Are you interested in information?
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Hearts Release
October 15th candle lighting ceremony
Christmas Luminaries
Bereaved Mother’s Day- Held In May
Dad’s division gatherings
Required
Would you like to learn more about becoming a volunteer? You don’t need to be local to Our Center for Loss in Latrobe Pa. We use Zoom for a once a month meeting. We really would love to expand across the state. You only need to give as much time as you can. We need people who want to help our cause. We have many opportunities! Virtual volunteering is a option!
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