LHF 2026 Family & Friends Day Registration (Saturday, May 2nd, 11:30AM-4PM)

Camp Istrouma, 25975 Greenwell Springs Road

This event is offered at no charge to any Louisiana resident with a bleeding disorder, as well as their family or friends.

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* 1. Full name and age of person with bleeding disorder

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* 2. Please provide the full name and age of any immediate family members or friends you will be registering. Registration is due by April 24, 2026.

Full name, age, and relationship of guest member 1

Full name, age, and relationship of guest member 2

Full name, age, and relationship of guest member 3

Full name, age, and relationship of guest member 4

Full name, age, and relationship of guest member 5

Full name, age, and relationship of guest member 6

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* 3. Phone number that you can be reached at during the day?

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* 4. Please provide email address.

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* 5. Do any of the guests you are registering have a food allergy? If so, please list name(s) and food allergen below. If not enter N/A.

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* 6. Assumption of the Risk and Waiver of Liability Relating to

Illness/Injury:

BY ADDING MY ELECTRONIC SIGNATURE, I confirm that I have read and agree to all terms and conditions of this waiver and understand that my electronic signature is legally binding.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the LHF Family & Friends Day, May 2, 2026, or participation in LHF programming (“Claims”). On behalf of myself, I hereby release, covenant not to sue, discharge, and hold harmless the Louisiana Hemophilia Foundation, its employees, contractors, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Louisiana Hemophilia Foundation, its employees, agents, and representatives, whether a illness or injury occurs before, during, or after participation in any LHF program.

I acknowledge the contagious nature of any illness and voluntarily assume the risk that I may be exposed to or infected by illness by attending the LHF Family & Friends Day, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by an illness at the LHF Family & Friends Day may result from the actions, omissions, or negligence of myself and others, including, but not limited to, LHF employees, volunteers, and program participants and their families.

Transportation Acknowledgment:
I understand and agree that I am responsible for my own transportation to and from the event. I acknowledge that I may choose to drive myself or voluntarily participate in a carpool arrangement, and I assume all risks associated with my chosen method of transportation, including those related to weather, road conditions, and travel circumstances.

The Louisiana Hemophilia Foundation (LHF) PHOTO RELEASE Consent:

I hereby grant the LHF permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

I understand and agree that all photos will become the property of the LHF and will not be returned.

I hereby irrevocably authorize the LHF to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge the LHF from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

MY ELECTRONIC SIGNATURE BELOW INDICATES THAT I HAVE READ AND UNDERSTAND THE ABOVE LIABILITY AND RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED. PLEASE TYPE IN YOUR ELECTRONIC SIGNATURE BELOW:

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* 7. Questions or comment? We welcome all!