LHF 2025 Annual Meeting Fall Festival Sponsoring Industry Partners Registration

LHF 2025 Annual Meeting Sponsoring Industry Registration

Doubletree Hotel

1521 W Pinhook Road, Lafayette, LA 70503

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* 1. Full name(s) of those attending on behalf of your company.

Name:

Name:

Name:

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* 2. Company Name

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* 3. Phone number of each company representative attending.

Phone #:

Phone #:

Phone #:

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* 4. Please provide email address of each representative.

Email:

Email:

Email:

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* 5. Accident/Injury Liability Waiver

I, the undersigned, being aware of my own health, limitations, and physical condition, acknowledge that I am voluntarily participating in the LHF Annual Meeting, 11/10-12/2023.

Having such knowledge, I understand that I am solely responsible for my personal safety and hereby release LHF, its representatives, agents, and event site host from liability for any accidental injury that may result from participation in this program.

I also accept this liability on behalf of my child(ren), and furthermore agree to supervise adequately to prevent injury.

Yes

No

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* 6. 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

Yes

No

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* 7. Conference Conduct Policy
To ensure a respectful and inclusive environment for all participants, discussion of religion or politics is not permitted during this conference or its related activities. By checking yes, you agree to uphold this policy and contribute to a positive, welcoming atmosphere for everyone.

Yes

No

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* 8. Questions or comment? We welcome all!