Child Life Events Form

Child Life Event
Event Name*
Hosted by*
Please enter the name of the Regional Group associated with this event.
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Audience Type*
Cost/Fee*
Location Type:*

VirtualIn-Person
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Description
Are there exhibiting opportunities for ACLP in this event?*

YesNo
Please provide additional details about exhibiting at your event you may have.
Is there an opportunity for ACLP Leadership to engage with your board leadership at this event?*

YesNo
Please provide additional details about engagement opportunities with your board.
Who can be listed as a contact for this event?*
Should be Empty: