Memorial Ceremony RSVP and Angel Story Submission

Memorial Ceremony RSVP and Angel Story Submission
We welcome families, friends and supporters to join us as we honor the memory of the children who lived bravely on earth and now live forever in our hearts at our Memorial Candle Lighting Ceremony.

Monday, September 30, 2024 │ 6:00pm

Grier Pavilion Rooftop - Riverside City Hall

3900 Main St, Riverside, CA 92501

RSVP

Complete the below form to join us to honor and remember our special angels.

CAN'T ATTEND?

Complete the form to include your child in the ceremony in your absence. We will provide access to a private Zoom link to participate in the ceremony from home.
RSVP

Please indicate how many guest(s) will be attending the ceremony
Will you be attending the ceremony?*

YesNo
Number of ADULTS*
Number of CHILDREN*

DETAILS ABOUT YOUR ANGEL

Complete the below information if you have an Angel you would like to honor in the ceremony.

IF YOU ARE ATTENDING IN SUPPORT OF OUR ANGEL FAMILIES: Please skip to the next page to complete your RSVP.
Angel's FULL NAME

First NameLast Name
Date of Birth

MonthDayYear
Date
Date of Passing

MonthDayYear
Date
Cancer Diagnosis
Please provide what kind of cancer they were diagnosed with.
Share your Angels story with us
There is no maximum length - share all that you would like to share with us.
Upload a photo(s) to share of your Angel. Please include your child's photo for the memorial table. (if you have trouble uploading photos, please send them via email to: kids@ccfsocal.org)

You can upload as many photos as you'd like. Incluya la fotografía de su hijo/a para la mesa conmemorativa.
Cancelof
By submitting this form I understand and I hereby grant Childhood Cancer Foundation of Southern California, Inc. (“CCFSC”), and their agents the absolute right and permission to use the provided photos and information of Child, for any lawful purpose whatsoever, including but not limited to use in any CCFSC publication or websites, without payment or any other consideration. I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, wherein Child’s likeness appears, or the use to which it may be applied. I hereby release, discharge, and agree to indemnify and hold harmless CCFSC and their agents from all claims, demands, and causes of action that I or Child have or may have by reason of this authorization or use of Child’s photographic pictures, digital images or information.
Signature

Clear

Your Information

Please provide your contact information below so we can contact you with any additional questions or ceremony information.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Can we text you to this number?*

YesNo
Email*
example@example.com
Should be Empty:

Memorial Ceremony RSVP and Angel Story Submission

RSVP

Your Information