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"Recordando a Nuestros Niños"

Registration/Update Form



We are trying to make your experience at the Memorial Service a positive one. Below you will find the electronic form to preregister for the event which will be April 5, 2014. If you have attended before, please fill out the form and check the box "Updating Information". If this is your first time to attend, please check the box, "First Time Attending".

When you have filled out the form, click the "Send my information" button. Your information will not go anywhere but to us; we will never share or sell your information. On April 5, to check in, just let them know that you preregistered and you will be able to go in without delay.

We look forward to seeing you on April 5.

Prefix
First Name
Last Name
Suffix
Address
City
State
Zip
Child(ren) to be honored
Date(s) of Passing
Relation to child
Phone #
Preferred e-mail address
Approximate # attending service
Updating Information?
1st Time To Attend?

Contact Information


Driscoll Children's Hospital
3533 S. Alameda Street
Corpus Christi, Texas 78411

(361) 694-5000
(800) DCH-LOVE or (800) 324-5683


For TTY Deaf Messaging Connect to TTY Interpretation by dialing
(800) 735-2989