Where are you from?:

Your Email Address:

Baby's Full Name:

Your relationship to the baby:

A baby boy or girl?
Boy
Girl

Are you authorized to give permission for this baby's name and photo to be used for SIDS Families projects?
Yes
No

Do you give permission for this baby's name and photo to be used for SIDS Families projects, such as the SIDS Awareness t-shirts?
Yes
No

Baby's birth and death dates typed out in long format - Month/Day/Year NOT numbers such as 2/12/99:

Does this baby have a nursery page here at SIDS Families? (If not, one will be created in memory of your baby with the photo and information submitted.)
Yes
No

Photo Details: How did you submit your baby's picture?

Previous Participant - photo is on file
Nursery Page
Emailed Photo
Photo can be found on a website

Please provide the URL (website link) directly to the photo (if that option was checked):
Please note that a photo does not end with an extension such as .html or .htm or .shtml or .asp or .php etc. Your photo URL should list a .jpg, .png, .bmp, .tif, .gif extension. If you are linking to a page instead of a photo, please also complete the following question.

Photo file name, caption associated with the photo, and/or description of the photo (if it's to be collected from a website):

Has your baby ever appeared in a previous edition of the t-shirts? (check all that apply)
Yes 2001
Yes 2002
Yes 2003
Yes 2004
Yes 2005
Yes 2006
Yes 2007
Yes 2008
No

Comments: