GVH 25th Annual Memorial Service

Please RSVP by November 20, 2010 so that your baby's name is included in the Memorial Service program.  If you did not name your baby, but would still like to include your baby in the service, we encourage you to use "Baby (last name)".

____ Will be attending the service (___ #)
____ Will bring ___hors d'oeuvre  ___dessert
____ Would like to participate musically
____ Would like to read a short poem or remembrance to the group
____ Enclosed a short message to be printed in the program
____ Cannot attend but would like our baby remembered
____ Would like to make a donation in memory of __________________________
(Please make check payable to Grand View Hospital)

Baby's Name: ________________________________________
Parent's Name: _______________________________________

Address: ______________________________________________________________________
_____________________________________________________________________________

___Please remove my name from the mailing list
___I cannot attend the service but would like to remain on the mailing list.

Please respond to:
Diane Carp
221 Kingfisher Court
Harleysville, PA 19438