CFSID Memorial Gallery Submission Form

Use this form to submit a baby's name to the CFSID Memorial Gallery or to update an existing entry.

Red Fields indicate Required Fields on this Submission Form.

Your name:
Email:
Relationship to SIDS Baby:

New Entry or Entry Update: New Entry | Entry Update
Baby's Full Name:
* Please note that names more than 30 characters long will be shortened to fit on the memorial marker.
Baby's Gender: Male | Female

Baby's Date of Birth:
Baby's Date of Passing:

Preferred Memorial Marker Message:
Or
Type your own Brief Message:


Please select a Memorial Marker:



















NEW! You can use
your baby's picture
as a marker.
Please send your
desired photo to
.

If a marker is
not selected,
one will be
chosen for you.
Do you have an existing memorial
web page created for this baby?
Yes | No

If yes, enter the URL of the page here:

If you do not have an existing memorial web page and would like to include a text memorial statement, poem or wish to share your story, you may either include this here or email this statement to our CFSID Webmaster at

For best results, either include your statement as a MS Word attachment or as text in the email itself.

Include the name of the SIDS Baby in the Subject Line of the email message.

If you would like to include a photo link as part of the memorial marker, please email the scanned photo to our CFSID Webmaster at .

Please ensure that it is a fairly large scan. We will resize it for posting.

Please note that only TIF, BMP, JPG or GIF images are acceptable for photo email attachments. Please include the name of the SIDS Baby in the Subject Line of the email message.

Questions / Comments

If you have any questions or comments, please enter them here.

Thank you for submitting your entry to the CFSID Memory Gallery: