Celebration Circle

***We respect your privacy. Any information you share with Lyla's Legacy will be kept confidential and used only for Celebration Circle. Public recognition is always optional and will only occur with your permission.

Name

First NameLast Name

Age of honoree at time of submission

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birthdate or important milestone date

Name of Parent/Guardian/Caregiver/Nominator

First NameLast Name

Email

example@example.com

Phone Number (Optional)

Please enter a valid phone number.Format: (000) 000-0000.

What are their favorite things? (colors, toys, songs, TV shows, snacks, etc.)

What makes them smile the most?

Do they have special interests, hobbies, or favorite characters?

Are there any sensory sensitivities or allergies we should know about?

Any specific type of gift that would bring them joy (or should be avoided)?

Does your honoree enjoy music and singing, or should we avoid loud sounds?

Are there any accessibility or communication preferences we should know about?

Tell us a little bit about them — anything that makes them special, proud moments, or a fun fact:

By selecting an option below, I understand and agree to the following:Photos and videos may be used for the purpose of celebrating and promoting inclusion through Lyla’s Legacy social media, website, and printed materials.I can withdraw consent at any time by contacting Lyla’s Legacy. ***First names only or initials may be used in showcasing individual being celebrated***

Signature

Date