For assistance with this form, to update your address or to add more than three losses, please email Megan at database@briefencounters.org.
For parents with different last names, include one parent’s first name in the First Name field and that same parent’s last name in the Last Name field followed by “&” and the second parent’s first and last name. For example, for Jill Smith & Tom Jones, enter “Smith & Tom Jones” in the Last Name field.
By filling out this form, you agree to allow Brief Encounters to share your baby name(s) and date(s) in “Our Children Remembered” section of our digital newsletter and our private Facebook group Please note that our newsletter is now published online. If you prefer us not to share this information, please do not include your baby’s name(s)/date(s) on this form. Thank you.