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Reservation Form for Bereaved Parents

To provide you with the best possible experience at Faith’s Lodge, your reservation form must be filled out completely. Please be assured that all information will remain confidential. We regret that we will be unable to review and process incomplete forms. A $50 non-refundable fee must accompany your guest reservation. Every effort will be made to honor your requested date of stay; however, space is limited. Reservations are processed in the order received and all information is confidential




  • Reservation fee: $50 (one-time fee per family, per stay)
  • First-time guests: $99/per night/per room
  • Returning guests: $249/per night/per room


    Parents staying at Faith's Lodge
    Emergency Contact
    • Referral Source

      Abbott Northwestern/ Mother Baby CenterBeliEVE FoundationBest Christmas EverCoulee Region Angels of HopeEthan's ReasonGundersen (RTS)Ridgeview Medical CenterHalos of the St. Croix ValleyLasting ImprintOpsahl-Kostel Funeral HomeRehkamp-Horvath Funeral ServicesSomeone elseI was not referred by anyone
    • Referrer Details

      Referrer Details

    Hospital Source
    Scholarships/Financial Assistance
    • Please enter the code from the lower left corner of your gift certificate
    Payment Options (please check one)*

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    Cancellation Policy

    Faith’s Lodge reserves the right to make schedule modifications as needed based on demand, conditions and other unforeseen circumstances.  Should your program date be changed or cancelled by Faith’s Lodge, such changes will be communicated at the earliest possible date.  Faith’s Lodge will attempt to reschedule the stay, but if rescheduling is not an option for the guest, then Faith’s Lodge will refund the registration fee.  Should the guest need to reschedule their reserved stay for any reason, registration fees can be applied to a future program of the guest’s choice.  Registration fees are non-refundable if a guest cancels (and chooses not to reschedule).