2023 BDASC 50th Annual Meeting and HELLO Conference

Personal Information

* First Name:
* Last Name:
* Email Address:
* Confirm Email Address:
* Address 1:
* City:
* State:
* ZIP Code:
Phone:
* Cell Phone:
*
For this event and others, may we contact you with reminders, etc. by text? (if we have a new system in place)
- Yes, I will like to receive text messages for this and other events of BDASC, thanks!
- Yes, only for this event please.
- No, I do not want to receive any text messages please, thanks!

You may add a maximum of 6

* First Name:
* Last Name:
Is participant an adult or child under 18?
- Adult
- Child under 18
If child under 18, please list age of participant.
If participant is a teen- (Ages 13-18 years), will they be participating in the teen programming with Gut Monkey? Please note: Teens will not be allowed to remain in the hotel room alone, per hotel rules.
- Yes, register my teen in the teen programming. I will be sending in my waiver forms.
- No, my teen will be participating with me during the annual meeting.
If participant is a child (Ages 1-12 years), will you be registering for the Child Care services provided free to BDASC members while available. If children remain with you during the meeting, they must remain with you at all times. They are not allowed by hotel contract to stay in any hotel rooms alone.
- Yes, I will be sending in my child care registration form to the Chapter. Please register my child.
- No, we do not need child care services. Children will remain with parents.

* Please indicate any food allergies or restrictions in diet and what you would like us to provide as a substitute if available.
*
BDSC will provide hotel accommodations on Friday, June 9th for members who must travel over 30 miles to attend this event and plan to stay for the Conference on June 10. If you live over 120 miles one-way, we will also provide a second night stay on Saturday, June 10th while rooms are available. We have a limited amount of rooms on a hotel block for the Sat night. We will do our best to try and accommodate your needs. However, we can only provide one room per family.
- Please reserve me/us a double/double room for 1 night, June 9th, 20223.
- Please reserve me/us a king bed room for 1 night, June 9th, 2023.
- We qualify for an additional night stay if the hotel is available, please reserve June 10, 2023.
- Thank you, but we do not need any room accommodations.

* I understand that I must read all the information posted on the annual meeting web-page that is available about this event in the downloadable information and registration forms so I will have all the details of this event, which will help to make it an enjoyable experience. I also understand that while I registered for this event, I am not confirmed for hotel accommodations until I receive a room confirmation letter from the chapter.
*
I understand and have read the Photo Release / COVID 19 Mitigation Waiver / and Behavior Requirement and agree to the terms for attending this conference.
- Yes, I agree and have read the information on the website.
- No, I do not agree and understand my application may be denied.