Your Name:
Your email address:	(e.g.: you@aol.com)
Your mailing address:
Your Angel's Name:	(Please include baby's full name)
Date of birth:	(If it was a miscarriage, please write in miscarriage)
Date of death:
additional comments:
Name of Poem:
Your Poem:

By submitting poetry to Angel Babies Forever Loved, Inc. you agree to the following terms: I hereby consent that the poetry which I have submitted may be used by Angel Babies Forever Loved, Inc., its asigns or successors, in whatever way they may desire, including audio/visual productions and television; Furthermore, I hereby consent that such poetry shall be the property of Angel Babies Forever Loved, Inc. and they shall have the right to sell, duplicate, reproduce or make other uses of such poetry as they may desire, free and clear of any claims on my part. I grant Angel Babies Forever Loved, Inc. a royalty-free, non-exclusive license to publish my entry(ies) in other of Angel Babies Foever Loved books and related publications. Furthermore, I acknowledge that I may use any poetry submitted to Angel Babies Forever Loved, Inc. on any of my own personal web pages or sites, written productions, etc. I am not waiving my right to the use of my poetry, I am only granting Angel Babies Forever Loved, Inc. the rights outlined above. Submission of your poetry means that you have read and agree to the terms listed above.