Request to Add a Name on
"Our Children Remembered"



I would like to have the name of the following deceased child/sibling
listed on the Internet on the "Our Children Remembered"page.

Enter the name as you would like it to appear


Date of Birth
Date of Death
Favorite Color
Favorite Song
Favorite thing
Favorite song 2
Death caused by

My child's name can appear in/on:
The web site
Name Only "web site"
News Letter

Please enter their relationship to you
(Son, Daughter, Brother, Sister)



Please enter your information below
First and Last Name

Address,City, State & Zip

Phone Number
Email Address

If you have a Memorial Page that you would like to have
linked to the name, please enter the URL (page address).
I would like to make a love donation: Yes No
Comments or Questions

Some will contact you with in 48 hours

Because the Internet is open to the public, you must agree to the following in order to have your child's name, picture or
anything else that is to be added to their personal page to appear on the web site or news letter.
By clicking the submit button on this request form you are releasing The Compassionate Friends and TCFMyrtleBeach.com
& webmaster from any and all liability of any use that may become of the name by others who see it.



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