2021 Pediatric Virtual Retreat
Thank you for your interest in participating in the 2021 Pediatric Virtual Retreat through the U.S. Pain Foundation. The retreat will take place over two weekends, December 3-5th and December 10-12th.  We hope you will enjoy the fun-filled virtual retreat. We promise educational, support and most important fun activities for the pediatric pain warrior, the parent/caregiver and the family as a whole.
There will be a kick-off welcome party on Friday, December 3rd at 7pm ET and a farewell-Get the Scoop on 2022 on Sunday December 12th at 7pm ET.  During the closing party we will be sharing very exciting news about what is to come in 2022!  The retreat is free to everyone!  Please complete the following application by Friday Nov. 19th to guarantee your retreat box will ship in time for you to participate in all activities. These boxes are on a first come first serve bases!
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Email *
Name of parent/caregiver *
Name of pediatric pain warrior and age *
Do you have more then one pediatric pain warrior *
If you have more then one pediatric pain warrior-what is their name and age
Additional children who will be participating in events and their age (if no other children please just write n/a) *
Street address where we can mail the retreat box *
City *
State *
zip code *
Where did you hear about the retreat *
Is this your first retreat with the pediatric pain warrior program *
Would you like to be added to our email list to keep up-to-date regarding upcoming events *
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