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Registration Form - TBL
I'm so sorry for your loss.

I can't do anything to help families with the LOSS, but I can help with the GRIEF.

Please let me know a little about yourself and the child or adult who passed, so I can get the Legacy properly set up for you. Your contact information will remain strictly confidential.


Information about the child

Information about the child

Full name of child or adult

Full name of child or adult


Date of birth

Date of birth


Date of passing

Date of passing


Parent's first and last names (if applicable)

Parent's first and last names (if applicable)


Information about you

Information about you

First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

What is your relationship to the child or adult?

What is your relationship to the child or adult?


Do you prefer being contacted by email or by text?

Do you prefer being contacted by email or by text?

Has the obituary already been published?

Has the obituary already been published?

If no, would you like to include the Legacy option in the obituary?

If no, would you like to include the Legacy option in the obituary?

Your friends and relatives need to hear about the Teddy Bear Legacy.

Your friends and relatives need to hear about the Teddy Bear Legacy.

Teddy bears won't be donated unless your friends and family are told about the Teddy Bear Legacy. Then they can visit MamaBearsPlace.com/TeddyBearLegacy and place an order. Some families let their friends and family know via social media, emails or phone calls. Are you willing to tell them about  the Legacy?

Who will receive the teddy bear donations my friends and family make?

Who will receive the teddy bear donations my friends and family make?

I personally take all the teddy bear donations to UNM Children's Hospital (University of New Mexico, in Albuquerque, NM), where their Child Life professionals give them to children who need extra comfort to help them cope with their treatments.


Thank you for registering for the Teddy Bear Legacy

Thank you for registering for the Teddy Bear Legacy

I will be in touch with you within 24 hours.


Donna Luke

Creator/Owner

MamaBearsPlace.com