Please fill out the form below to be added to the SpringFest WAITLIST.
If space becomes available, you will be called and emailed a separate registration link. Questions? Please contact Carrie McCulloch cmcculloch@hfmich.org, 734.961.3503.
What is your registration type?
*
Please Select
Community Member
HFM Staff
HFM-Invited Speakers
Hemophilia Treatment Center Staff
Industry Representatives
Industry-Invited Speakers
Does someone in your immediate family have a bleeding disorder? Please note: SpringFest is only open to individuals with bleeding disorders and their immediate family members.
*
Yes
No
Who should be contacted if space becomes available?
*
First Name
Last Name
What Phone Number should we call if space becomes available?
*
What e-mail should we send a registration link to if space becomes available?
*
example@example.com
How many adults should be added to the waitlist?
*
Please Select
1
2
3
4
How many children should be added to the waitlist?
*
Please Select
0
1
2
3
4
5
6
7
8
9
10
If space becomes available, will you need us to reserve a hotel room(s) for you on Saturday night?
*
Yes, I would need hotel accommodations.
No- I would attend, but would be responsible for my own accommodations.
How many people do you anticipate would stay at the hotel?
*
Please Select
1 - 4 people
5 - 8 people
9+ people
If you will be traveling more than 3 hours (approximately 180 miles) you may be eligible to receive a hotel nights stay on Friday night. Would you like to be added to the waitlist for a Friday night hotel room?
*
Yes
No
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