Virtual: Garden City Education – Midwest Hemophilia

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Date
Date(s) - July 31 2020

Location

Category(ies)

Education

**For health safety purposes, Garden City Education Night is going virtual & is now open to ALL of our community members and families!**

Along with some fun education, we’re including prizes, food gift cards, and a registration box that will be mailed to each household that registers! You don’t want to miss this fun, interactive event!

This is the registration form for virtual Garden City Education event.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Email*
Number of Adults Attending?*
Please enter a number from 1 to 100.
Number of Children (ages 0-10 Years)
Please enter a number from 0 to 100.
Number of Children (11-17 Years)
Please enter a number from 0 to 100.
Type of bleeding disorder:
- Hemophilia A
- Hemophilia B
- Von Willebrands
- Platelet Disorder
- Other
If "Other" please describe: