Rare Disease Day Event | Registration Form

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Please use this form to register for the 2023 Rare Disease Day Event, to be held on February 25, 2023 at the Prince Conference Center on the campus of Calvin University.

Submitting this form indicates that you have read and agree to the event waiver.

Email *

Name (first and last)

I am a:

Community Member

Educator

Rare Family Member

Health Professional

Rare Disease Advocate

Person with a Rare Disease

Researcher

Student

Other:

Do you represent an non-profit organization involved with rare disease that would be interested in hosting an informational table at this event?

Yes

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(optional) The rare disease(s) with which I have experience:

Which of the following is your preference for lunch:

Southwest Salad (vegetarian and gluten free)

Chicken and Kale Wrap

Ham and Cheddar Croissant

Clear selection

Following is a list of breakout sessions that will each be offered twice during the event. What are your top choices (select two)? This will help us schedule sessions in appropriately sized rooms.

Starting and Working with Rare Disease Foundations

Unique Careers, Common Goals (careers in rare)

Courage Doesn't Always Roar (parent advocacy)

MI Able Disability Savings Program

From Discovery to Treatment (rare disease research)

Would you or someone attending with you benefit from access to a sensory space?

Yes

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Are there other members of your household attending with you? *

Yes, other adults only

Yes, including at least one minor

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