California Rare Action Network Picnic at the Park Survey

1.First name(Required.)

2.Last name(Required.)

3.Email Address(Required.)

4.Please list the names and ages of each person you are registering to attend, including yourself.(Required.)

5.What town do you live in?(Required.)

6.What state do you live in?(Required.)

8.Photo Release Form(Required.)

I grant the National Organization for Rare Disorders the right to take photographs of all registered guests in my group in connection with this event. I authorize NORD to copyright, use and publish these photos in print or electronically. I agree that NORD may use such photographs of me with or without my name and for any lawful purposes of publicity, illustration, advertising, social media (Facebook) and web content.

I do not grant the National Organization for Rare Disorders the right to take photographs of all registered guests in my group.