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A Healing Journey On Butterfly Wings

Sunday, June 26, 2011, 3:00 to 4:00 pm Klehm Arboretum and Botanic Garden 2715 S. Main Street, Rockford Celebrate loved ones who have died by releasing live Monarch butterflies in their memory. You may wish to remember: family and friends • fellow members of organizations, clubs, churches or temples • co-workers and employees

The Grief Center of Northern Illinois Hospice

Following a short remembrance service in the Fountain Garden, we will release the butterflies. Music and refreshments will follow. A live butterfly release to benefit

The Grief Center of Northern Illinois Hospice

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A Healing Journey: On Butterfly Wings Registration Name _________________________________Address_____________________________City_____________________State____Zip______ Phone _________________________________________________Email ______________________________________________________ Seating is limited, so please tell us how many of your family/friends will be attending with you:________________________________________  Yes, please reserve ____ butterflies to be released. ($25 each/$100 for five)  No, I cannot attend, but please reserve ________ butterflies and release them for me.  No, I cannot attend, but please accept my tax deductible donation. Butterflies to be released in memory of:* ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ *The names of your loved ones will be acknowledged in the program book.

Total amount enclosed $ ______ Check Visa Mastercard Card # ___________________________________ Expiration Date ___/___ Name on Card___________________________________________Signature ____________________________________________________ We have ensured that proper protocols are followed for the release of the butterflies through the assistance of Swallowtail Farms. Unclaimed butterflies will be released by 4:15 to ensure that none are harmed. In the event of rain, the service will proceed (bring your umbrella) and the butterflies will be released at the earliest opportunity.

Return this form with your payment by June 15, 2011, to: The Grief Center of Northern Illinois Hospice • 4215 Newburg Road, Rockford, IL 61108 815-398-0500 • lnovak@northernillinoishospice.org


A Healing Journey: On Butterfly Wings