HFM Women's Empowerment Retreat

HFM Women's Empowerment Retreat
Dates: July 25 – July 27, 2025

**RSVP Deadline:** May 15, 2025

Location: Rod N' Reel Resort, 4160 Mears Avenue, Chesapeake Beach, Maryland 20732

Important Registration Information

Due to limited funds and high demand, space for the HFM Women’s Retreat is limited. Registration does not guarantee confirmation of your reservation or attendance.

After the RSVP deadline, all applications will be reviewed, and confirmations will be sent based on the following criteria. If we are unable to accommodate you, any deposits will be refunded upon request. Thank you for your understanding.

Priority Guidelines for Selection:

1. Women from newly diagnosed families receive first priority.
2. Next, priority is given to women in need of respite or support, including those who have experienced a medical or family emergency within the past year.
3. Following that, priority is given to women from rural areas, where geographic distance may create challenges in attending regular programming.
4. Lastly, priority is given to women whose families actively support HFM programs and initiatives.

Deposit & Confirmation Details:

A non-refundable deposit of $25.00 per attendee is required to secure your spot for the Women's Empowerment Retreat.

⚠ **Please note:** Registration alone does not guarantee attendance. Your attendance is only confirmed once you receive your official confirmation email. Confirmation emails will be sent out on May 20, 2025.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Person with a bleeding disorder:

I have hemophiliaI have vWDI have a Platelet DisorderMy spouse has vWDMy spouse has HemophiliaMy spouse has a Platelet DisorderMy child has vWDMy child has HemophiliaMy child has a Platelet Disorder
Space for the HFM Women's Retreat is limited. Are you willing to share a room with another guest? While not required, this would help us accommodate more participants at the event.

YesNo
Your T-shirt Size

Adult SmallAdult MediumAdult LargeAdult XLAdult 2XAdult 3XAdult 4XAdult 5X
Please describe the Bleeding Disorder affecting you or your immediate family:

Hemophilia A mildHemophilia A ModerateHemophilia A SevereHemophilia B MildHemophilia B ModerateHemophilia B Severevon Willebrand DisorderPlatelet Disorder
Where do you or your immediate family receive their bleeding disorder care?*

Johns Hopkins Hemophilia Treatment CenterChildren's National Medical CenterGeorgetown Hemophilia Treatment CenterDuPontChristianaHershey Medical CenterOther
To ensure we accommodate your needs appropriately, do you have any food allergies or dietary restrictions?Please specify any allergies (e.g., nuts, shellfish) or dietary requirements (e.g., vegetarian, gluten-free).
To ensure our Women's Retreat addresses your interests, are there specific educational topics you'd like HFM to explore or discuss?
Participant Acknowledgment and Agreement:

Arrival Commitment: I understand that by registering for this retreat, I am committing to arrive promptly by 4:00 p.m. on July 25, 2025.

No-Show Policy: I acknowledge that if my registration is confirmed and I fail to attend the event without prior notice, I will be responsible for a no-show fee equivalent to the full cost of my reservation.

Program Participation: I agree to actively participate in all mandatory programming scheduled during the retreat.

By proceeding with the registration, I confirm that I have read, understood, and agree to the terms outlined above.
Signature

Clear
Good Faith Non-Refundable Deposit - $25.00

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USDNon-Refundable Good Faith Deposit - if you registration is not confirmed, this deposit will be REFUNDED.

Pay with Credit Card

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