(Unfortunatly, this form cannot be filled out here, but this form can be copied, simply highlight the text and hit Ctrl/C, then go into a document and do Ctrl/V or contact Donna with the information) 

 

    All of our children’s names that were one the benches are now on the two bridges in Vilas Park. This form is to request any new names to be added. This information will also be added to our database, to receive our newsletter and other information. Please print or type the following information. Child’s Name (only first & middle names on the plaque) First Name________________________ Middle Name ______________________ Last Name _________________________ Birthdate ___________________ Deathdate ______________________ Parent name (s) Mother _________________________ Father _______________________ Stepparents (if applicable) _________________________________ Address ____________________________________________________ Phone Number ____________________ Email ____________________ Send To: Donna Knickmeyer 14118 Selwood Dr. Prairie du Sac, WI 53578 wdknick@charter.net 608-225-0072 (if you have any questions) All forms must be received by May 9th . Any form received after this date, the name will be placed on the plaque next year. There is no cost for this but a Love Gift is always appreciated.