#StrongerTogether World Tour 2022 Registration #StrongerTogether was our theme for the 2022 International Barth Syndrome Scientific, Medical, and Family Conference. COVID-19 dampened our ambitions to come together in Florida for the Conference, yet we continue to believe that We Are #StrongerTogether. The BSF Community never, ever gives up on our ideals, so we are hitting the road to be #StrongerTogether around the globe. We look forward to seeing you at #STWT2022! Question Title * 1. Contact information of the person completing this formNote: Make sure the email you provide is accurate, we will be sending an email with more registration details to this email. First and Last Name * Address * Address 2 City/Town * State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Country * Email Address * Phone Number * Question Title * 2. Will you be staying at the Great Wolf Lodge? No Yes Unsure Question Title * 3. Which events will you be attending? (Select all that apply, even if you do not plan on staying at Great Wolf Lodge).Travel grants are available. Visit the BSF #STWT2022 webpage for more information. Fitchburg/ Boston, Massachusetts (Fri, Jul 8 - Sun, Jul 10, 2022) ($240/night) Gurnee/ Chicago, Illinois (Sun, Jul 24 - Tue, Jul 26, 2022) ($165/night) LaGrange/ Atlanta, Georgia (Fri, Oct 7 - Sun, Oct 9, 2022) ($250/night) Scottsdale, Arizona (Fri, Oct 21 - Sun, Oct 23, 2022) ($205/night) Question Title * 4. First and Last Name of of adult(s) who will be attending Adult 1 Adult 2 Adult 3 Adult 4 Adult 5 Adult 6 Adult 7 Adult 8 Adult 9 Adult 10 Question Title * 5. First and Last Name of child(ren) who will be attending Child 1 Child 2 Child 3 Child 4 Child 5 Child 6 Child 7 Child 8 Child 9 Child 10 Question Title * 6. Will you be needing BSF-sponsored Great Wolf Lodge attraction passes? If so, how many? (Recommended for children aged 4-14) No Yes (please specify how many) Question Title * 7. Do you anticipate joining us for dinner at 6:00pm local time on the first evening of the event you registered for? No Yes Unsure Question Title * 8. Which of the following meals will you be joining? (Times are currently estimates) Day 2 - Breakfast (8:30-9:30am local time) Day 2 - Lunch (12:00-1:00pm local time) Day 2 - Dinner (5:00pm local time) Day 3 - Breakfast (8:30-9:30am local time) None Question Title * 9. Do any attendees have dietary restrictions? Select all that apply. Vegetarian Vegan Halal Kosher Gluten-free Food Allergy Food Sensitivity None Other (please specify) Question Title * 10. Please list the foods to which you have an allergy/ sensitivity Question Title * 11. Youth Tee Shirts Select the number of #STWT commemorative tee shirts by size you wish to order for your group Quantity Small 0 1 2 3 4 5 6 7 8 Small Quantity menu Medium 0 1 2 3 4 5 6 7 8 Medium Quantity menu Large 0 1 2 3 4 5 6 7 8 Large Quantity menu Question Title * 12. Women's Tee Shirts Select the number of #STWT commemorative tee shirts by size you wish to order for your group Quantity Small 0 1 2 3 4 5 6 7 8 Small Quantity menu Medium 0 1 2 3 4 5 6 7 8 Medium Quantity menu Large 0 1 2 3 4 5 6 7 8 Large Quantity menu XL 0 1 2 3 4 5 6 7 8 XL Quantity menu 2XL 0 1 2 3 4 5 6 7 8 2XL Quantity menu Question Title * 13. Men's Tee Shirts Select the number of #STWT commemorative tee shirts by size you wish to order for your group Quantity Small 0 1 2 3 4 5 6 7 8 Small Quantity menu Medium 0 1 2 3 4 5 6 7 8 Medium Quantity menu Large 0 1 2 3 4 5 6 7 8 Large Quantity menu XL 0 1 2 3 4 5 6 7 8 XL Quantity menu 2XL 0 1 2 3 4 5 6 7 8 2XL Quantity menu 3XL 0 1 2 3 4 5 6 7 8 3XL Quantity menu Question Title * 14. Media Release (Adult)I grant permission to the Barth Syndrome Foundation (BSF) to use my image or likeness for use in BSF media publications. I waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown. Response Print Yes No Print Response menu Email Yes No Email Response menu Social Media Yes No Social Media Response menu Website Yes No Website Response menu Videos Yes No Videos Response menu Question Title * 15. Media Release (Minor Children)I grant permission to the Barth Syndrome Foundation (BSF) to use my image or likeness for use in BSF media publications. I waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown.Note: If no children are attending, please select N/A for each option. Response Print Yes No N/A Print Response menu Email Yes No N/A Email Response menu Social Media Yes No N/A Social Media Response menu Website Yes No N/A Website Response menu Videos Yes No N/A Videos Response menu You are not done yet! Please hit the next button to continue. Next