Community Candlelight

Reservation Information

Your Name *

First

Last

Email *

Are you a Stepping Stones Family ?

Donation Amount

$10.00 - One Luminaries
$20.00 - Two Luminaries
$30.00 - Three Luminaries
$40.00 - Four Luminaries
$50.00 - Five Luminaries
$60- Six Luminaries
$70- Seven Luminaries
$80- Eight Luminaries
$90-Nine Luminaries
$100- Ten Luminaries
Other

*The suggested donation of $10/luminary provides grief support to children & families at this event & throughout the year

Other

Luminary Information

Your Last Name

All luminaries will be in alphabetical order around the lagoon, by the person who reserved the luminaries last name. Please indicate your last name for this purposes.

Luminary 1 Name

1. Veteran

True
False

Luminary 2 Name

2. Veteran

True
False

Luminary 3 Name

3. Veteran

True
False

Luminary 4 Name

4. Veteran

True
False

Luminary 5 Name

5. Veteran

True
False

Luminary 6 Name

6. Veteran

True
False

Luminary 7 Name

7. Veteran

True
False

Luminary 8 Name

8. Veteran

True
False

Luminary 9 Name

9. Veteran

True
False

Luminary 10 Name

10. Veteran

True
False

RSVP Information

I plan to attend Community Candlelight. *

How many people, including yourself, will be attending? *

Please list names of all those attending: *

Would you like to Sponsor a Luminary for a Stepping Stones Family?

No
Yes, I would like to Sponsor in addition to my own reservation.

Sponsor Amount

$10.00 - One Luminaries
$20.00 - Two Luminaries
$30.00 - Three Luminaries
$40.00 - Four Luminaries
$50.00 - Five Luminaries
$60- Six Luminaries
$70- Seven Luminaries
$80- Eight Luminaries
$90- Nine Luminaries
$100-Ten Luminaries

Billing Information

Address

Address Line 1

Address Line 2

City

State

Zip Code

Stripe Credit Card

Card

Name on Card

Total

$0.00

Name *

First

Last

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