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Teen Weekend Registration
Friday - Saturday, July 14-16, 2023
Best Western Cotton Tree Inn (
10695 S Auto Mall Drive, Sandy)
Begins:
Friday, 6 pm
Ends:
Sunday, 2 pm
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* Indicates required question
Please list the names, birthdates, and bleeding disorder type of each teen attending
*
Your answer
Mailing Address
*
Your answer
Parent/Guardian Contact Information
(Name/Cell phone)
*
Your answer
Parent/Guardian Email
**Please check this email, frequently, as this is how we will communicate with you about this event.
*
Your answer
Teen(s) Email
**Please check this email, frequently, as this is how we will communicate with you about this event.
*
Your answer
Please check which nights your teen(s) will be sleeping at the Best Western:
*
Friday night, July 14
Saturday night, July 15
Required
Registration Fee:
*
I am able to pay the $25 registration fee for each teen attending
I cannot pay the full registration fee but, would like to make a donation
I am unable to pay the registration fee and request a fee waiver
I hereby give permission for my teen to participate in Teen Weekend activities and programs. I waive all rights to any future claims against the Utah Hemophilia Foundation, volunteers or representatives, due to any accident, injury, illness, or treatment of the same, that may occur.
I grant permission to the Utah Hemophilia Foundation to photograph, use pictures, visual and audio tapes, or written materials of me and or members of my family for professional, fundraising, educational or other purposes through any medium including print, television, radio or the internet.
*
I agree
Required
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