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

Please list your loved one's name(s) as you would like it to appear on their luminary below.

Your Last Name

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

Loved One Name 1

1. Veteran

True
False

Loved One Name 2

2. Veteran

True
False

Loved One Name 3

3. Veteran

True
False

Loved One Name 4

4. Veteran

True
False

Loved One Name 5

5. Veteran

True
False

Loved One Name 6

6. Veteran

True
False

Loved One Name 7

7. Veteran

True
False

Loved One Name 8

8. Veteran

True
False

Loved One Name 9

9. Veteran

True
False

Loved One Name 10

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

Office Use Only

Name *

First

Last

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