2025 TopGolf

HFM at TopGolf- WAITLIST

This event is now FULL. Please fill out the following information to be added to our waitlist. In the event that space opens, HFM will contact you.

Thank you to sponsor, CSL Behring for providing this fun and educational night!

Please note that we are unable to provide travel reimbursements or overnight accommodations for this event.
Number of Adults to be added to the Waitlist*
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Second Adult

First NameLast Name
Third Adult

First NameLast Name
Fourth Adult

First NameLast Name
Number of Children to be added to the waitlist*
First Child

First NameLast Name
Second Child

First NameLast Name
Third Child

First NameLast Name
Fourth Child

First NameLast Name
Fifth Child

First NameLast Name
Sixth Child

First NameLast Name
Seventh Child (if you have more than seven children, please contact Carrie McCulloch at cmcculloch@hfmich.org, or 734-961-3503).

First NameLast Name
Photo/Recording Release

It is HFM’s pleasure to host community members at various events throughout the year. By documenting these events through photo and/or video we hope to maintain a historical record of community activities, share photos for future events or activities, and promote fundraising efforts that support HFM events and services. It is a joy to reminisce when looking through photos, we hope to preserve community memories and moments.
I consent to and authorize the use and reproduction, in print or electronic format by the Hemophilia Foundation of Michigan (HFM), or anyone authorized by HFM, of any and all photographs or video of me/my child(ren) which have been taken for this event, for any publicity, without compensation. I understand that all images and quotations of/by me/my child(ren)—electronic, print, and recordings—are owned by HFM which may publish or use them in any professional manner, including, but not limited to: print publications, websites, social media, and broadcast media. I acknowledge that I am 18 years of age or older and have read and understood the terms of this release.I do not authorize or permit the Hemophilia Foundation of Michigan (HFM) or its authorized agent to use photos and/or video of me/my child(ren).
Signature

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Photo/Recording Release