Usher Syndrome in Louisiana

Usher Syndrome in Louisiana

Symposium and Ush One See/Walk Registration
If you have questions or need assistance, please email USHinLA@lsuhsc.edu or visit lsuh.sc/msUSHinLA.
Attendee's First Name*
Attendee's Last Name*
Tell us who you are:*

Individual with UsherRelativeHealthcare ProfessionalOther
Do you have any accommodation needs? Please list them here.
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which events do you plan to attend?*

Usher Syndrome in Louisiana 5th Symposium - Friday, September 1910th Annual USH One See Run/Walk - Saturday, September 20
Are you registering another attendee?*

YesNo
2nd Attendee
2nd Attendee's First Name*
2nd Attendee's Last Name*
How does your 2nd attendee identify?*

Individual with UsherRelativeHealthcare ProfessionalOther
Does your 2nd attendee have any accommodation needs? Please list them here.
Event 1: Usher Syndrome in Louisiana 5th Symposium

Friday, September 19 in Lafayette, LA
Would you like a box lunch?*

YesNo
Please list dietary requirements:
Would 2nd attendee like a box lunch?*

YesNo
Please list dietary requirements of your 2nd attendee:
Event 2: 10th Annual USH One See Run/Walk

Saturday, September 20 at River Ranch in Lafayette, LA
Which race are you participating in?*

1 Mile Fun Run5K
*Please note that a $35 payment per person is due to participate in the Ush One See 1 Mile Fun Run per person. You can pay when you arrive to the race or you can pay in advance on the Ush One See website. Click here to register and pay with Ush One See.
*Please note that a $40 payment per person is due to participate in the Ush One See 5K Run/Walk. You can pay when you arrive to the race or you can pay in advance on the Ush One See website. Click here to register and pay with Ush One See.
Which race is your 2nd attendee participating in?*

1 Mile Fun Run5K
What is your age on September 20th, 2025?*
What is your 2nd attendee's age on September 20th, 2025?*
How do you identify?*

MaleFemaleI prefer not to say
How does your 2nd attendee identify?*

MaleFemaleI prefer not to say
Do you identify as visually impaired?*

YesNo
Does your 2nd attendee identify as visually impaired?*

YesNo
Who is your emergency contact?*

First NameLast Name
Emergency Contact's Phone Number*
Please enter a valid phone number.
What is your t-shirt size?*
What is your 2nd attendee's t-shirt size?*
Should be Empty:

Usher Syndrome in Louisiana

2nd Attendee

Event 1: Usher Syndrome in Louisiana 5th Symposium

Event 2: 10th Annual USH One See Run/Walk