Family Circle Rose Dedication Program

Packages for Families & Individuals

A rose is a symbol of love, loss and renewal.It represents something different to every family; to some it is hope, to others it is grief and to still others it is gratitude.

The Family CircleRose Dedication Program offers all families touched by organ and tissue donation the opportunity to honor their loved ones by dedicating a rose tagged with a personal message and placed in the Family Circle Garden.The Garden is a living memorial on the Donate Life Rose Parade Float, which as part of the Tournament of Roses Parade in Pasadena, Californiais seen by tens of millions of people worldwide on New Year’s Day.

Proceeds from the Family Circle support three important goals:

Honor Your Loved One:portions of the funds go back into the program to create the opportunity to honor your loved one through the Rose Dedication Program.

Inspire People:The Family Circle inspires people to donate life by contributing to the Donate Life Rose Parade Float and sponsoring the official float website, Each year the Donate Life float is the subject of over 250 news stories nationwide, is seen by millions of viewers and spectators, and is one of the largest national donation campaigns.

Support Families: The Family Circle will reserve funds to create exciting feature projects dedicated to support and honor families touched by donation.This year we pleased to offer a Pilgrimage to Pasadena to one of our Family Circle Families.

Family Circle Dedication Packages

Individual families may choose from one of four Family Circle packages:

The Family Circle Rose Bud:$25

  • A rose with the name of your loved one or honoree in the Family Circle Garden
  • Thank you card acknowledgingyour dedication
  • Your personalized dedication posted on

The Family Circle Rose Blossom: $50

  • A rose with the name of your loved one or honoree in the Family Circle Garden
  • Thank you card acknowledgingyour dedication
  • A personalized certificate recognizing the gift of a loved one or honoree
  • A replica of the vial placed in the Family Circle Rose Garden
  • Your personalized dedication posted on

The Family Circle Rose Bouquet: $100

  • A rose with the name of your loved one or honoree in the Family Circle Garden
  • Thank you card acknowledgingyour dedication
  • A personalized certificate recognizing the gift of a loved one or honoree
  • A replica of the vial placed in the Family Circle Rose Garden
  • One Rose Parade Souvenir 3-Pin Set (Float Theme, Parade Theme, Rose Logo Pins)
  • One Rose Parade Souvenir Program
  • Your personalized dedication posted on

Family Circle Rose Dedication Program

Packages for Families & Individuals (cont’d)

The Family Circle Rose Garden: $200

  • A rose with the name of your loved one or honoree in the Family Circle Rose Garden
  • Thank you card acknowledgingyour dedication
  • A personalized certificate recognizing the gift of a loved one or honoree
  • A replica of the vial placed in the Family Circle Rose Garden
  • Two Rose Parade Souvenir 3-Pin Sets (Float Theme, Parade Theme, Rose Logo Pins)
  • Two Rose Parade Souvenir Programs
  • Five Float Theme pins
  • Your personalized dedication posted on

Your rose dedication form must be received by:

  • December 1st for your dedication package to be delivered by Christmas
  • December 15th for your dedication package to be delivered by New Years Day
  • December 27th for your rose to ride in the FamilyCircleGarden and package to be received by January 30th

Family Circle Rose Dedication Program

Order Form for Individual Families

I am proud to join the Family Circle at the following level:

(Please complete an order form for each rose you wish to dedicate)

The Family Circle Rose Bud$25

The Family Circle Rose Blossom$50

The Family Circle Rose Bouquet$100

The Family Circle Rose Garden$200

Write Your Dedication:

This rose is for a:

Family Circle Rose Dedication Program 221 South Figueroa Street, Suite 500 Los Angeles, CA90012 (213) 229-5600 Fax (213) 229-5601

Deceased Donor to honor a loved one’s life and memory

Living Donor to honor his/her gift of life

Transplant Recipient to honor his/her renewed life

Transplant Candidate to support someone
waiting for the gift of life

Transplant Candidate to honor one who
died waiting for the gift of life

Supporter of Organ and Tissue Donation

Family Circle Rose Dedication Program 221 South Figueroa Street, Suite 500 Los Angeles, CA90012 (213) 229-5600 Fax (213) 229-5601

Introduction: choose one with the name of the honoree

In memory of

In honor of

In support of

Personal Dedication (optional): up to 25 words that will be added to the end of the introduction:

Your Name

Address

CityStateZip

Email (or Phone if no email)

Enclosed is my check payable to Family Circle.

Please charge my credit card:VISAMasterCardAmex

Credit Card #Exp

Name on CardSignature

Note: Your card statement will show a charge to “OneLegacy,” the Southern California transplant donor network that coordinates the Donate Life Rose Parade Float.

OPTIONAL: Please acknowledge my gift and send my Family Circle Dedication Package to:

Name(s)

Address

CityStateZip

Please mail or fax this order form to the address below, Attn: Donate Life Float Family Circle. An email confirmation will be sent upon receipt of your order. The Donate Life Float Family Circle is coordinated by OneLegacy, a 501(c)3 non-profit organization, Tax ID #95-3138799.

Donations are tax-deductible to the maximum extent allowed by law.

Family Circle Rose Dedication Program 221 South Figueroa Street, Suite 500 Los Angeles, CA90012 (213) 229-5600 Fax (213) 229-5601