Community Outreach Program: Kansas City

With a focus on Hemophilia A, this dinner education program is for individuals and families living around the Kansas City area. Come hear Cath Tiggs present, Move Beyond the Threshold.

Registration ends June 12th.

June 18th Community Outreach Registration

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 Date of Birth 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 Date of Birth 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.

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Date
Date(s) - June 18 2022 at 6:00 PM

Location
Grand Street Cafe

Category(ies)

First Name	Last Name	Date of Birth	Diagnosis

First Name	Last Name	Date of Birth	Diagnosis