Key Contact Form

When a child dies….

A wife who loses a husband is called a widow.

A husband who loses a wife is called a widower.

A child who loses his parents is called an orphan.

There is no word for a parent who loses a child.

That’s how awful the loss is.

Jay Neugeboren – An Orphan’s Tale – 1976

 

By submitting any information down below, you are agreeing to be contacted by Kids Joining Eternity. You can also click Kids Joining Eternity Key Contact Form and email the completed form to melanie@kidsjoiningeternity.org and let us know how we can help you. All it takes is a few minutes.

Your Name (required)

Date (required)

Check all of the areas you are interested in participating/receiving information (required)

Your Email (required)

Your Mailing Address (required)

Your City, State, Zip Code (required)

County Live In (required)

Your Preferred Phone Number (required)

Are you over 18? (required)

Have you ever lost a baby/child? If Yes, how long ago since your last loss? (required)

If Yes, please list the date(s) of your loss(es) and how far along you were each time: (required)

Who referred you to contact Kids Joining Eternity? (required)

Do you prefer a phone call, text message or email for initial contact? (required)

Is there a time of day/day of the week that is best to contact you? (required)

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