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RSVP to the Butterfly Release Memorial

How will you be attending the annual Butterfly Release?

In-person, outdoors at the Ronald McDonald House next to CHEO’s Main Campus

Viewing the virtual ceremony

I will not be attending

Name of the child/youth you are remembering (please note: the name(s) will be read during the ceremony):

Photo of the child/youth you are remembering (Optional. Please note the photo will be shared during the virtual ceremony and will not be used during the in-person event):

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About you

First name:

Last name:

Email address: (please note your email address will only be used to provide you with information about the Butterfly Release Memorial. At no point will we use your email address for any other purpose)

Phone number (optional):

Would you like to remain on our list to receive future invitations?

Yes

By completing this web form, you will be asked to share your/your child/youth’s personal information and potentially personal health information. This may include, but may not be limited to, your name, contact information (e.g. email address, phone number), details about you/your child/youth and information about your/your child’s/youth’s previous visits to CHEO. This information is being collected for the purpose of care planning and so that CHEO can better assist in providing support services to you/your child/youth. Your information remains confidential and will not be used for any other purpose, except as required or permitted by law. If you have questions about the use, collection and disclosure of your personal information and personal health information, please contact privacy@cheo.on.ca.

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RSVP to the Butterfly Release Memorial

About you