Together as a community we will make Wild Rose Days a success!
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Proud Supporters
Dedicate a Firework to a special some one!!
$15 Donation
*
NONE
Cylinder Flash Salute
Kiddy Fishes in Crowds / Crackling Shells
Popping Brocade with small flowers
Gold Rippling Peony
Green to Silver Peony
Orange to Lemon Peony
Blue Peony
Green to Purple Peony
Gold Wave to Crackling
Gold Wave to Color w/Palm
Blue Violet Peony
Two Break Variegated Peony
Two Break Green Peony
Custom Card - Anniversary ($5 additional cost)
Custom Card -Birthday ($5 additional cost)
Custom Card - General ($5 additional cost)
$25 donation
*
NONE
Flash Chrysanthemum Shell
Silver Wave Chrysanthemum Shell
Green Leaves / Willow & Thunder
Glittering Silver to Yellow Chrysanthemum
Red, White & Blue Glitter
White Twinkling Chrysanthemum
Variegated Color Chrysanthemum
Red Gamboge to Purple Chrysanthemum
Gold Chrysanthemum
Red Gamboge to Blue Chrysanthemum
Blue Chrysanthemum with rising tail
Custom Card - Anniversary ($5 additional cost)
Custom Card - Birthday ($5 additional cost)
Custom Card - General ($5 additional cost)
LARGER DONATION AMOUNTS ($50 - $100)
*
NONE
$50 - 25 Glittering Silver Comet
$50 - 25 Assorted Peony
$100 - 300 Shot Fan - Red, White & Blue
$100 - 300 Shot Rainbow of Colors, Crakles & Whistles
$100 - 300 Shot - Christmas Tree Barage - zigzagging silver & green bullets
Custom Card - Anniversary ($5 additional cost)
Custom Card - Birthday ($5 additional cost)
Custom Card -General ($5 additional cost)
*
Indicates required field
How many of each would you like?
*
Name (Your name)
*
First
Last
Phone Number............... (in case of questions)
*
.......................Mailing Address............................. (line 1 = name to dedicate firework or card to) - (line 2 = mailing address to send card)
*
Line 1
Line 2
City
State
Zip Code
Country
Please send payment to:
(or drop off at Village Hall / Public Library)
Wild Rose Days
C/O - FIREWORKS
P.O Box 1
Wild Rose, WI 54984
If a form is submitted and no payment is received by July 10th your firework will not get dedicated
Submit