RSVP for VHF Adult Retreat Weekend

RSVP for VHF Adult Retreat Weekend

Friday, November 7 - Sunday, November 9, 2025
Eligibility Criteria

Thank you for your interest! Please read VHF's Program Registration Guidelines and verify that you are eligible to attend before filling out application. If you have any questions please email info@vahemophilia.org or call 804-740-8643.
PLEASE NOTE: The VHF Adult Retreat is designed for VHF constituents age 21 and up with inherited bleeding disorders and/or to adults whose lives are impacted by an inherited bleeding disorder (i.e. caregivers, spouses, carriers, immediate family members – some restrictions do apply) and is not open to individuals employed or compensated by Industry.

VHF Behavior and Program Registration Guidelines: Please read VHF's Behavior and Program Registration Guidelines before filling out event registration. If you have any questions, please email info@vahemophilia.org or call 804-740-8643.
I have read the VHF Behavior and Program Registration Guidelines.*

Yes
Attendee Information

Please fill name and contact information of attendees.
Your Name*

First NameLast Name
Email Address*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Is this your first Virginia Hemophilia Foundation (VHF) event/program?*

No.Yes.I am unsure.
If You Answered "Yes" or "I'm unsure" - Please Provide Your Current Physical Address.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If You Answered "Yes" or "I'm unsure" - Please Let Us Know How You Heard About Us.*

Referred by CHKD-HTC.Referred by UVA-HTC.Referred by VCU-HTC.Referred by other healthcare provider.Referred by friend or family member.Recently moved to the area.Internet Search.Social Media.Other
How many people (including yourself) will be attending?*

12
Please type the first and last name of your guest and their relationship to you. Please note that your guest needs to be age 21+ in order to attend this event. If you do not have anyone to add please type "N/A"*
Will you need overnight accomodations on Friday, November 7?*

Yes, and I will need VHF to pay.Yes, and I will be self-pay.No, I do not need overnight accomodations.
Will you need overnight accomodations on Saturday, November 8?*

Yes, and I will need VHF to pay.Yes, and I will be self-pay.No, I do not need overnight accomodations.
Would you be interested in joining VHF for an educational dinner on Friday, November 7?*

Yes.No.Maybe.
Would you be interested in joining VHF for an educational dinner on Saturday, November 8?*

Yes.No.Maybe.
Do you or anyone in your group have any dietary needs and/or restrictions that we should be made aware of? If so please list below, if the answer is "NO", write "N/A".*
Do you or anyone in your group have any mobility needs that will require assistance?*

YesNoMaybe
Do you or anyone in your group require an ADA compliant room? If the answer is "NO", write "N/A".*
PHOTO RELEASE: I hereby authorize and permit the Virginia Hemophilia Foundation and its authorized agent to use my photograph, voice and/or likeness, with or without my name or the name of the person for whom I am the parent/guardian, in its sole discretion as it sees fit, free and clear of any claim whatsoever on my part, and without compensation.*

I have read and YES I agree.I have read and NO I do not agree.
Should be Empty:

RSVP for VHF Adult Retreat Weekend

Eligibility Criteria

Attendee Information