Floating Bye Donation and Dedication form

Thank you for your interest in Floating Bye. To join one of our ceremonies and / or dedicate a flower please complete the donation form below. Your donation will help us to support families in Northland living with dementia. Thank you.

Amount

$100

$50

$25

Donation Schedule

Contact Information

Name

First Name

Last Name

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Ceremonies

Which ceremony would you like to attend?

Waitangi 10am Sunday 9th Dec

Ruakaka 3pm Sunday 9th Dec

I am unable to attend, please float a flower on my behalf

Dedication

Name of the person or people you would like to remember

Add 3% to my total amount to help cover the payment processing fees