Family Education Weekend 2021

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Date
Date(s) - September 25 2021 until September 26 2021

Category(ies)

This is our 29th year to host our annual education conference for the bleeding disorders community! We hope you will join us for a weekend to learn, grow, and connect. Free childcare, youth, and teen activities provided.

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
How will you be attending?*
If online you will receive an Zoom Meeting Invite prior to the event start with the link provided to login.
- In Person
- Online
***Must live more than 120 miles from location
- Please reserve a hotel room for us on Friday, Sept 24, AND Saturday, Sept 25th
Hotel Reservation
- Please reserve a hotel room for us on Saturday, Sept 25th.
- We will not need a hotel room either night.
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.
Registration Fee & Annual Dues
Price:

First Name	Last Name	Date of Birth	Diagnosis

First Name	Last Name	Date of Birth	Diagnosis