TO BENEFIT HOSPICE & PALLIATIVE CARE

TO BENEFIT HOSPICE & PALLIATIVE CARE

$25 per butterfly or five for $100

The highlight of the Butterfly Releases will be the individual release and flight of hundreds of Monarch butterflies to honor someone for a special occasion; or memorialize loved ones by sponsoring a butterfly

in their name. There will be live music, the reading of names and refreshments after the event on the beautiful grounds of Utica College and Herkimer College. Both locations are handicap accessible.

According to American Indian legend, if someone whispers a wish to a butterfly and then releases it, that wish will come true...

There are a limited number of butterflies available. To ensure you have a butterfly to release that evening and acknowledge your loved one in our program, please mail your form today. If you are not able to attend the Butterfly Release Celebration, we will be happy to release your butterflies for you. After July 5th please call for availability of butterflies.

For more information, call Hospice at (315) 735-6484 or visit our website at

Proceeds from all Hospice events support our palliative services, hospice care and bereavement services in Oneida, Herkimer and Eastern Madison Counties.

Sponsored by:

Limited butterflies available! Complete and return this form today!

Four Easy Steps to Participate: 1. Print your name and information. 2. List those you with to celebrate. Each butterfly is $25 or 5 for $100. 3. List those you wish to receive an acknowledgment. 4. Make checks payable to: Hospice & Palliative Care or charge your gift below.

Donor Name(s) Street City Email

State

Zip

Phone ( )

I would like to reserve

(# of butterflies) at $25 each or $100 for 5 for a total of $

Please check a location: Utica College Herkimer College

Will you be attending the event? Yes No

Please RSVP so we may plan accordingly.

I would like to support the work of Hospice with a donation of $

Name of person to be recognized (write additional names on back):

We are honored to read every name. Due to limited space, we can not list special occasions or messages.

Please send an acknowledgment card of my gift to: (write additional acknowledgments on back)

Name

Street

City

State

Zip

No acknowledgment is necessary to someone other than myself.

Credit Card Transaction

Card Holder's Name:

Billing Address (if different):

Visa

MasterCard

Credit Card #:

Discover Exp. Date:

3-Digit Security Code:

Mail form to: Hospice & Palliative Care, Inc; 4277 Middle Settlement Road, New Hartford, NY 13413 For more information, call (315) 735-6484 or visit our website at After July 5th please call for availability of butterflies.

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