Redeem Your Voucher – R.G.

This form is to Redeem your voucher for a FREE personalized Phoenix Bear customized to your baby’s weight (plus embroidery and/or angel wings for a small $7 fee each)
FREE SHIPPING for your Phoenix Bear has been gifted to you by Rachel’s Gift, Inc.

*If you would like to request your Free Phoenix Bear (weighted to your baby’s weight) holding a blanket / lovey with NO add on’s, please CLICK HERE for original form! You get free shipping either way (gifted to you by Rachel’s Gift)!

Voucher Code Number *Voucher Code Number has a 1 time use only

Your First Name *

Your Last Name *

Email Address *

Confirm Email Address *

Street Address *We are currently only accepting orders from the U.S.

Apartment, suite, etc

City *

State *

ZIP Code *

Baby's Full Name *Enter First Middle & Last Name (if un-named, you can enter nickname or "N/A")

Baby's Gender *

Baby's Weight (ex: 5lbs 4oz) *How much your Bear will weigh* *If weight is unknown due to miscarriage, please enter baby's gestational age (we will then use average weight for that gestation for your bear).

Baby's Length (in inches) *

Date of Birth or miscarriage *

Voucher expires one year from your baby's Date of Birth or Date of Passing

Date of Passing (If after DOB)

Voucher expires one year from your baby's Date of Birth or Date of Passing

Theme, Colors, Patterns that you associate with your baby *We cannot guarantee this, but we do our best to accommodate up to 2 requests.

Attached Blanket *YesNoeach Phoenix Bear comes with a blanket attached to it's hand unless you opt out of this

Embroidery *

Embroidery for Belly Patch (up to 2 names)What you enter here will be exactly what is embroidered. NOTE: We do our best to fulfill requests but we can not guarantee more than one name will fit.

Embroidery for Blanket ~ Up to 3 lines but this depends on how many characters are in your requestEnter exactly what you want embroidered (space is limited so we can not guarantee your request will be possible but we do our best)

Additional InformationEnter any additional information you want us to know including but not limited to: If your baby's first name includes more than one name (ex: Mary Beth). Your baby's story (if you want to share it with us). Etc.

Bear's Main Color *color preference

Choose a Different Color in case your First Choice is not available *color preference

Base BearI will buy my own base bear from your Amazon WishlistChoose my base bear for me based on above color preference

Angel Wings *Yes ($7)No

Add a Birthday Bib & Hat for future birthdays? *NoPink (add $10)Blue (add $10)Yellow (add $10)Red (add $10)Choose Color for Me (add $10)Bib is approx. 5.5"W x 4.5" H & hat is approx. 3.5" H x 2.5" W base (works for most size bears)

Would you like to donate to Phoenix Bears? *Phoenix Bears is run solely on donations. Any donated amount over the expense of your custom bear will be donated to the next bereaved parent on the waitlist.

Receive Notifications?

Keep me updated with Phoenix Bears News!I'd like to learn more about Volunteer Opportunities

Total Charge

Total After Discount

Note: Please fill in all the required (*) fields - once you do, the "Pay" button will appear below.

Calculations

DiscountFree Embroidery $7

Total After Discount