Paper Heart Form

Paper Heart Form

For BLAW 2025
During Baby Loss Awareness Week (BLAW), Ayrshire Baby Loss Support proudly joins families, charities and communities across the world to remember every baby gone too soon and to raise awareness of pregnancy and infant loss.

Here’s how you can join us during BLAW:
✨ Turn your world pink and blue to help raise awareness
✨ Take part in our Scatter a Heart remembrance activity
✨ Light a candle with us for the Global Wave of Light on October 15th at 7pm

Our Committee Members and Befrienders will be scattering hearts during this week, if you would like one for your baby/babies, written and scattered by us, please complete the following form:
Baby's name*

First NameMiddle NameLast Name
Preferred date on heart

DayMonthYear
Date
Baby's name

First NameMiddle NameLast Name
Preferred date on heart

DayMonthYear
Date
Baby's name

First NameMiddle NameLast Name
Preferred date on heart

DayMonthYear
Date
Baby's name

First NameMiddle NameLast Name
Preferred date on heart

DayMonthYear
Date
If you require more hearts than the above form allows, please complete another form.
If we can help in any other way, or if you would like us to contact you about the support we offer please complete your details below:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Please add any information you would like us to know.
Should be Empty: