Community Member Registration for 2026 VHF Annual Meeting

Community Member Registration for VABDF Annual Meeting

March 13 - 15, 2026
The VABDF Annual Meeting is designed for VABDF constituents and their immediate family and/or household members.

Behavior and Program Registration Guidelines: Please read VABDF'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.
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.Format: (000) 000-0000.
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
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
YesNo
Guest/Family Member #1*

First NameLast Name
Age of Guest/Family Member #1 *
*IF OVER 18 WRITE N/A*
YesNo
Guest/Family Member #2*

First NameLast Name
Age of Guest/Family Member #2*
*IF OVER 18 WRITE N/A*
YesNo
Guest/Family Member #3*

First NameLast Name
Age of Guest/Family Member #3*
*IF OVER 18 WRITE N/A*
YesNo
Guest/Family Member #4*

First NameLast Name
Age of Guest/Family Member #4*
*IF OVER 18 WRITE N/A*
YesNo
Guest/Family Member #5*

First NameLast Name
Age of Guest/Family Member #5*
*IF OVER 18 WRITE N/A*
Yes, and I will need VABDF to pay.Yes, and I will be self-pay.No, I do not need overnight accomodations.
Yes, and I will need VABDF to pay.Yes, and I will be self-pay.No, I do not need overnight accomodations.
Yes.No.Maybe.
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".*
YesNoMaybe
Do you or anyone in your group require an ADA compliant room? If the answer is "NO", write "N/A".*
I have read and YES I agree.I have read and NO I do not agree.
Should be Empty:

Community Member Registration for VABDF Annual Meeting

Attendee Information