*1.Full Name(Required.)

*2.Company Name(Required.)

*3.Phone Number(Required.)

*4.Email Address(Required.)

*5.Do you have any food allergies? If so please list below. If not please enter N/A.(Required.)

*6.Each Cabin has two separate bedrooms. Please provide name of roommate. If you would like a private cabin let us know and there will be an addition charge.(Required.)

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

Illness/Injury/Accident:

I, and on behalf of family members and minor children I am registering, voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself or any family members and minor children I am registering, (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 2025 Men's Retreat, 7/18-20/2025, or participation in LHF programming (“Claims”). On behalf of myself and family members and minor children I am registering, 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 illness or injury occurs before, during, or after participation in any LHF program.(Required.)

Yes

No

8.Questions or comments? We welcome all.