Weighted Bears Order Form – Healing Embrace

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This Weighted Bear is requested for *

Myself Someone I know

Baby's Name (if known) *

Baby's birthdate *

Pounds *

If weight is unknown, please enter "unknown"

Ounces *

If weight is unknown, please enter "unknown"

Sex of Baby (if known) *

Male Female Unknown

Bear Color Preference *

Brown (10 pound max) Cream (13 pound max) No Preference Due to shipping and supply limitations as a result of COVID-19, we have a limited capability to make larger brown bears at this time.

Ribbon Color? *

Pink Blue Neutral

Recipient's First Name(s) *

Recipient's Last Name *

Who will the bear be shipped to? *

Ship to the recipient Ship to me No international shipping at this time.

Shipping Address

Address Line 1: *

Address Line 2:

City *

State/Province *

Zip/Postal Code *

Country *

Phone Number *

Use shipping address for billing? *

Yes No

Recipient's Story *

Email Address *

How did you hear about us? *

(*) Denotes a required. Must be filled out to submit form.

While we do our best to fill orders in a timely manner and try to help fill urgent needs quickly, please allow 4-6 weeks for delivery. *

I understand

Choose Bear or Care Package Only *

Add Care Package for $20+ tax?

Add Care Package to this order for additional $20 + 7% tax

If adding a care package, are there other children at home and what age(s)?

If adding a care package, should we include something for dad or siblings?

Yes, Both

Yes, Dad

Yes, Siblings

Add additional donation?

Free local pickup available in Omaha NE? *

Yes

No (adds $20 shipping to US only)

Payment *

Total:

Questions? Please email healingembrace@griefsjourney.org or call Sandy at (402) 502-2773

Thank you so much!

The purchaser/recipient agrees to hold HEALing Embrace (and its program partners, officers, directors, volunteers and staff) harmless against liability, damages, and expenses in respect to claims alleged to have been caused by the purchased item(s). No international shipping at this time.