Springfield Education Day – 2022

Come celebrate HarvestFest with your MHA community! Open to all bleeding disorders and their families, you don’t want to miss a great opportunity to get together, connect to resources, learn about financial wellness, & explore Rutledge-Wilson Farm.

Lunch and vouchers to use at Rutledge-Wilson Farm will be provided ONLY to those who register and attend our program. Registration closes October 19th!

*Explore Rutledge-Wilson Farm for as long as you prefer. They should be open until 6:00pm weather permitting. Some additional activities may be available for a small fee.

October 22th 2022 Springfield Education Day

Adults Attending:*
Click the PLUS sign next to the box to add more. Diagnosis examples: Hemophilia A, Hemophilia B, von Willibrands, Carrier, Other, N/A
First Name Last Name Age Diagnosis
Kids attending:
Click the PLUS sign next to the box to add more. Diagnosis examples: Hemophilia A, Hemophilia B, von Willibrands, Carrier, Other, N/A
First Name Last Name Age Diagnosis
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email
Photo Consent Opt Out -From time to time, the Midwest Hemophilia Association (MHA) will want to use pictures and/or videos from our events to promote bleeding disorder programs and MHA's activities. Please check the box below if you would NOT like to grant permission to be able to use your image or those who have registered for that purpose.
- No I do NOT consent to the use of pictures of videos.
Number of Family Members for Inflatables (Bounce House, Obstacle Course, Slide)
Number of Family Members for Hay Ride (Ages 5+, Under 4yrs free with paid adult)
Number of Family Members for Corn Maze (Ages 5+, Under 4yrs free with paid adult)
Number of Family Members for Cow Train (Ages 3+, Under 2yrs free with paid adult)
Number of Family Members for My Little Farm Inflatable (Must be under 3yrs old)

Thank you to the following sponsors:

	…			…

	…		…

Map Unavailable

Date
Date(s) - October 22 2022 at 9:00 AM - 12:30 PM

Location
Springfield Botanical Center Facility

Category(ies)

Education

First Name	Last Name	Age	Diagnosis

First Name	Last Name	Age	Diagnosis