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LHF 2024 Annual Women's Retreat May 17-19, 2024, Poter's Mark Beach Houses, Gulf Shores, Alabama (Open to women with a bleeding disorder, female caregivers, siblings, grandmothers, or mothers of those with a bleeding disorder 18 years and above)

1361 West Beach Blvd, Gulf Shores, AL 36542
Space is limited for this event.

1.Name of Registering Attendee(Required.)
2.Relationship to female with bleeding disorder?(Required.)
3.Full name of person you are related to with a bleeding disorder.
4.Email Address(Required.)
5.Phone Number(Required.)
6.Date Of Birth(Required.)
7.Bleeding Disorder Type(Required.)
8.Will you be staying in our beach house accommodations? Rooms bunk house style with some shared and are first come first serve upon arrival. (Required.)
9.LHF will be providing bus service to this event. Will you be riding the bus or driving to the facility?(Required.)
10.Do you have any food allergies or restrictions? If so please list.(Required.)
11.Assumption of the Risk and Waiver of Liability Relating to

Illness/Injury

By checking yes to this this agreement, 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 Women's Retreat, 3/31-4/2/2023, 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 Women's Retreat, 5/17-19/2024, 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.

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 Women's Retreat, 5/17-19/2024, 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, 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.

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.

I HAVE READ AND UNDERSTAND THE ABOVE PHOTO 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(Required.)
12.Questions or comments? We welcome all.
Current Progress,
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