HCC Health Care Access Forum 2/2/2023
Register to attend the Health Care Access Forum on Feburary 2, 2023. This Forum is a HYBRID in person/virtual event that will take place from 10:00 am to 12:00 pm.  Registration and Networking starts at 9 AM in person / 9:15 AM virtually.  Lunch is included for all attendees after the Forum. In person meeting location is at the California Endowment Center for Healthy Communities (1414 K Street, Sacramento in the 1st floor Adelante Room).

For those wishing to attend virtually, you will receive your Zoom login information in late January for this Forum meeting.

PLEASE NOTE:  There is a SEPARATE registration for the Health Policy Summit in the afternoon on 2/2/2023.  To register for the Summit, you can visit https://www.hemophiliaca.org/health-policy-summit/.  

Registration is limited to Healthcare Access Forum members.  If you have not yet renewed your company 2023 membership, you can visit https://hemophiliaca.org/education/health-care-access-forum#Membership or email Lynne at lkinst@hemophiliaca.org.  Additional tickets are available to companies - you can purchase them at http://www.hemophiliaca.org/education/health-care-access-forum/
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Email *
First Name *
Last Name *
Title
Company
Phone Number
Attending in person or via Zoom? *
If you are attending in person, will you be participating in the networking hour? (Mark N/A if you are attending virtually.) *
If you are attending in person, lunch will be provided after the Forum. Will you be joining us for lunch?
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If you are attending in person, do you have any dietary restrictions?
If you are attending in person, the venue requires proof of full vaccination on the day of the event.  Can you provide proof of vaccination? (Mark N/A if you are attending virtually.) *
ATTENDEE LIABILITY WAIVER AND ASSUMPTION OF RISK:  In addition to all other rules and regulations relating to the attendee’s attendance at the Forum, attendee agrees to comply with all COVID-related procedures that may be implemented by Hemophilia Council of California and the California Endowment, including, but not limited to, proof of vaccination, mask-wearing and social distancing requirements and restrictions on certain activities that carry higher COVID-related risk, in order to protect as much as possible the health and safety of all Health Care Access Forum attendees.  Attendee assumes all risks and accepts sole responsibility for any injury (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that attendee may experience or incur in connection with attending the Health Care Access Forum. Attendee hereby releases, covenants not to sue, discharges, and holds harmless Hemophilia Council of California, its employees, agents, and representatives, of and from any such claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto.  Specifically relating to the global COVID-19 pandemic, attendee acknowledges the highly contagious nature of COVID-19 and voluntarily assumes the risk of exposure or infection by attending the Health Care Access Forum, and that such exposure or infection may result in personal injury, illness, disability, and/or death to attendee. Attendee understands that the risk of becoming exposed to or infected by COVID-19 at the Health Care Access Forum may result from the actions, omissions, or negligence of others who may attend the event or their families, colleagues, or others with whom they may have contact. Accordingly, attendee understands and agrees that this release includes any claims based on the actions, omissions, or negligence of Hemophilia Council of California, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in the Health Care Access Forum. *
MEDIA RELEASE:  During this program, photographs, audio and video may be taken to document the program. I hereby grant the HCC, its assignees, contractors, licensees, sponsors and transferees permission to record my likeness and voice and the right to use my likeness, voice and name in any professionally produced or distributed products or materials, for any broadcast of the products or materials, and any publicity for the aforementioned products or materials. I understand that such use may include publication, media reproduction, audio and/or video broadcast, internet distribution/access and other uses as desired by the HCC and its employees from and against any and all liability arising out of or connected in any way with the use of reproductions of my image, voice, or text. *
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