RSVP to the Service

Thanks for taking the time to RSVP to University of Virginia Children's Hospital Memorial Service, to be held on May 4, 2013 at 2:00 PM in McLeod Hall, University of Virginia School of Nursing.

The questions in italics require answers. If a question doesn't apply, just type "n/a" or the number "0". Make sure you click "Submit" at the bottom of the form. There is no need to mail the business reply card if you fill out this RSVP form.

Will you be attending this year's service? (Required)

Yes
No

We will be honoring: (Required)

Please provide child's FULL name (first, middle and last)

Please provide your name(s): (Required)

Number of adults attending: (Required)

Please include yourself.

Number of children attending: (Required)

Will you be needing childcare? (Required)

Yes
No

Please list ages of children needing childcare. (Required)

Number of wheelchair accessible seats needed: (Required)

Add "n/a" if not applicable.

Will you require a sign language interpreter? (Required)

Yes
No

Will you need a language interpreter? If so, list language: (Required)

Add "n/a" if not applicable.

Would you like to be invited again next year? (Required)

Yes
No

Please provide your address, so that we can update our mailing list: (Required)

Please provide your phone number, in case we have a question about your registration: (Required)

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