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2. Donor Information
4. First Name
5. Last Name
7. Address
9. City
10. State
11. Zip
13. Email
14. Phone Number
16. Memorial Information
18. Name of person the memorial is for:*
20. Memorial Type

    1. Bench ($1,500)
    2. Tree ($400)

    (Includes a plaque, installation and maintenance)
21. Donation Type

    1. Check
    2. Online w/ Credit Card

    (After submitting the form, you will be redirected to the donation page if you would like to make an online donation)

23. Where are you interested in placing the memorial?
    (Liberty Parks & Rec staff will work with you on a final location based on your interest)
25. Memorial Decoration Policy*

    The tree/bench with plaque serves as the memorial for the loved one. Because memorial trees and benches are located in public use spaces, additional decorations in or around the tree/bench are prohibited as they can create a hazard or additional liability to park users. All additional memorials will be immediately removed by Liberty Parks & Rec staff. Memorabilia will be available for pickup at the Liberty Community Center for two weeks. Items will be disposed of following the two week period.

    1. I have read and agree to this policy
27. Bench Plaque
    (4 lines of 40 characters per line maximum for bench)
28. Tree Plaque
    (50 characters maximum including spaces and symbols)
30. NOTICE

    After you submit this form, you will be directed to the Liberty Parks & Rec Foundation donation page where you can select Memorial Bench or Memorial Tree from the drop down menu to make a donation.

32. Thank You
    Thank you for your interest in purchasing a memorial tree or bench. We will process your request and a member of our team will get back to you with further details. If you have any additional questions, please contact Tom Garland at 816.439.4384 or tgarland@libertymo.gov
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field