• 2026 YOU Matter! Women’s Retreat Registration Form

  • Welcome!

  • We're excited to invite you to the 2026 YOU Matter! Women's Retreat, a special weekend designed to bring together women affected by bleeding disorders for education, connection, support, and relaxation.

    Who Can Attend?

    The retreat is open to women who are:

    • Members of the Eastern or Western Pennsylvania Bleeding Disorders Foundation;
    • Aged 16 years and older; and
    • One or more of the following:
      • Living with a diagnosed bleeding disorder;
      • A carrier of a bleeding disorder;
      • A parent, caregiver, or partner of someone with a bleeding disorder; or
      • A sibling or daughter living in the same household as someone with a bleeding disorder.

     

    Retreat Schedule | November 20–22, 2026 | Hershey Lodge | Hershey, Pennsylvania

    The agenda is subject to change. We will share a final agenda with registered attendees closer to the event.

    Friday, November 20
    4:00-5:00 PM
    Registration

    4:00-6:00 PM
    Optional Massages (Note: massage appointments will be available on a first-come, first-served basis. Sign-ups will take place on-site when you arrive at the retreat)

    6:00 PM
    Dinner

    6:30 PM
    Welcome & Opening Activities

    7:30-8:30 PM
    Opening Keynote: YOU Matter!

     

    Saturday, November 21
    8:30-9:00 AM
    Optional Morning Wellness
    Choose from yoga or meditation.

    9:00-10:00 AM
    Breakfast & Exhibits

    10:00 AM-12:00 PM
    Educational Sessions

    12:00-1:00 PM
    Lunch & Exhibits

    1:00-1:30 PM
    Optional Wellness Break
    Choose from yoga or meditation.

    1:30-2:30 PM
    Educational Session

    2:30-3:15 PM
    Small Group Conversations

    3:15-4:00 PM
    Educational Breakout Sessions

    4:00-5:00 PM
    Cardio Drumming

    5:00-6:00 PM
    Free Time

    6:00-7:00 PM
    Dinner

    7:00 PM
    Optional Evening Activities


    Sunday, November 22
    8:00-9:00 AM
    Breakfast

    9:00-10:00 AM
    Morning Wellness Session

    10:00-11:00 AM
    Chapter Updates & Closing

    11:00 AM
    Retreat Concludes & Hotel Check-Out


    The agenda is subject to change. We will share a final agenda with registered attendees closer to the event.

  • Before You Begin The Registration Form


    This registration form will take approximately 5 minutes to complete.

    Some questions ask about your experiences with bleeding disorders and advocacy. Your responses will help us tailor educational sessions, discussions, and activities to best meet attendees' needs.

    Thank you for helping us create a meaningful retreat experience!

  • SECTION 1 — Primary Participant

  • Format: (000) 000-0000.
  • Would you like to receive text messages regarding this event?*
  • SECTION 2 — Tell Us About Yourself

  • Your Date of Birth?*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Your Bleeding Disorder Foundation Affiliation

    Please select the primary organization you are a member of. To attend the retreat, you must be a member of either the Eastern Pennsylvania Bleeding Disorders Foundation or the Western Pennsylvania Bleeding Disorders Foundation.

    Not a member? No problem. If you are not currently registered as a member but are eligible, you can still register for the retreat. Select “None”. We will contact you and provide a membership registration form to complete before attending. Membership is free and connects you with educational programs, events, resources, support, and other opportunities available through your local Bleeding Disorders Foundation.

  • Select the primary organization with which you are a member.*
  • Select the Hemophilia Treatment Center with which you are affiliated.*
  • If you have a bleeding disorder, select the bleeding disorder from the list below. Otherwise, select Not Applicable.*
  • Your relation to the person(s) with a bleeding disorder (select all that apply):*
  • SECTION 3 — Hotel Accommodations

  • Do you need a hotel room?*
  • The hotel rooms and conference center are under one roof. However, there is some distance to walk between these areas of the facility, and there are a limited number of hotel rooms located close to the conference center. Guests with mobility or accessibility needs will be given priority for rooms closest to the conference center. If you do not have a physical limitation or other reason to need a room closer to the conference center, we kindly ask that you consider your fellow attendees when indicating your preferred hotel room location.

    If you require a wheelchair or scooter for longer distances, we strongly encourage you to bring your own, if possible. The hotel has a limited number of scooters available for a rental fee of $40 per day. Scooters cannot be reserved in advance and are available to hotel guests on a first-come, first-served basis. Because availability is determined by the hotel, the Foundations cannot guarantee that a scooter will be available during your stay.

    If you have a mobility or accessibility need and are able to rent one of the hotel's scooters during the retreat, the Foundations will cover the rental cost. Please indicate your mobility needs on this registration form so we can plan accommodations to the best of our ability.

  • Do you require an ADA accessible room?*
  • Would you prefer a room closer to the conference center if available?*
  • SECTION 4 — Dietary Needs

  • We understand that attendees may have various dietary restrictions and preferences, and we will do our best to accommodate them. Please share your dietary needs during registration so we can communicate them to the hotel's catering team.

    While we take dietary restrictions seriously and will do our best to accommodate your needs, we cannot guarantee that every specific dietary requirement can be met. If you have a severe food allergy or dietary restriction, we encourage you to plan accordingly and contact us with any questions or concerns so we can help you prepare for the weekend.

  • Do you have a special diet?*
  • SECTION 5 — Additional Participants

  • Would you like to register another participant?*
  • Additional Participant
  • SECTION 6 — Advocacy

  • What advocacy topics would you find most helpful to discuss during the Women's Retreat? (Select all that apply.)
  • SECTION 7 — Wellness Sessions

  • During the retreat, there will be opportunities for you to participate in two optional wellness sessions. Each session will offer a choice of yoga or meditation.

    You do not need to make a final decision until the day of the retreat. However, indicating your preferences in advance will help us plan the best we can for the room setup and supplies. While we encourage you to bring your own yoga mat, if you have one, we may have some available to borrow.

    Please indicate which wellness activity, if any, you are interested in participating in for each session below.

  • Saturday, November 21, 8:30 – 9:00 AM (Before Breakfast)*
  • If available, would you like to borrow a yoga mat for this session?*
  • Do you have an additional participant who wants to join you for the yoga/meditation on Saturday morning?*
  • If available, does your additional participant need to borrow a yoga mat for the morning session?*
  • Saturday, November 21, 1:00 – 1:30 PM (After Lunch)*
  • If available, would you like to borrow a yoga mat for this session?*
  • Do you have an additional participant who wants to join you for the yoga/meditation on Saturday afternoon?*
  • If available, does your additional participant need to borrow a yoga mat for the afternoon session?*
  • SECTION 8 — Agreements

  • BEHAVIOR

    All individuals attending the You Matter! Women's Retreat should be assured the opportunity for (1) unencumbered access to information and resources, and (2) a safe, welcoming, and non-threatening environment in which they can share information, interests, and ideas. Under no circumstances will we allow the participation of members of the bleeding disorders community or other attendees to be compromised by threatening language, intimidating behavior, or disruptive actions.

    Participants will treat one another with respect and consideration to create a collegial, respectful, inclusive, and professional environment. Creating a supportive environment where everyone feels welcome to learn, connect, and share experiences is the responsibility of every participant. To that end, we believe setting forth a clear set of behavioral expectations promotes an atmosphere of dignity and respect for all.

    We appreciate and value individual differences and welcome diversity in its broadest definition. Many different opinions and experiences may be shared during our events that may touch you personally and often emotionally. While we strongly encourage passion as you share your stories, we offer the following guidelines to help keep conversations respectful and productive:

    1. Attack the problem, not the person. There will be differences of opinion. You may not agree with everything that is discussed. Please be open to hearing other people's perspectives. If you disagree, respectfully challenge the idea, not the person. Blame and judgment move us further from the solution, not closer. Honest and constructive discussions help achieve the best outcomes.
    2. Be assertive, not aggressive, when presenting your points.
    3. Share both positive and negative experiences respectfully and constructively.
    4. Problem-solve instead of placing blame.
    5. Humor is encouraged, but not at the expense of others.
    6. Choose words that encourage, engage, and enrich others.
    7. A positive attitude is contagious.  Your kindness and respect help create a welcoming community for everyone.
       

    Harassment-Free Environment

    We are committed to providing a safe, welcoming, and inclusive environment for all participants, volunteers, exhibitors, industry professionals, sponsors, guests, and staff.

    We will not tolerate any form of illegal discrimination or harassment based on a person's race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), or any other characteristic protected by law.

    Harassment includes offensive, aggressive, intimidating, or hostile behavior based on a protected characteristic. Examples include, but are not limited to:

    • Abusive verbal comments or slurs
    • Offensive or threatening language
    • Displaying offensive objects or images
    • Unwelcome physical contact
    • Any verbal or physical conduct that creates an intimidating, hostile, or offensive environment
       

    We expressly prohibit sexual harassment, including unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature.

    Participants who engage in behavior that violates this Code of Conduct will be asked to stop the behavior immediately. We reserve the right to remove any participant from an event without refund or reimbursement if their conduct is disruptive, threatening, discriminatory, or otherwise inconsistent with these expectations. Participants may also be prohibited from attending future events.

     

    Alcohol, Illegal Substances & Smoking

    Participants are expected to comply with all applicable federal, state, and local laws.

    Underage drinking and the use of illegal substances are strictly prohibited at all WPBDF and EPBDF events. Anyone violating this policy will be required to leave immediately and may be prohibited from attending future WPBDF and EPBDF events.

    Hershey Lodge is completely non-smoking. All indoor guest rooms, corridors, public spaces, and indoor meeting areas are strictly smoke-free.

     

    Event Attire

    Dress is casual and comfortable.

    Clothing displaying offensive language, images, or messages is not permitted. Participants may be asked to cover the clothing, change, or leave the event if their attire is deemed inappropriate.

     

    Medical Responsibility & Emergency Care

    While medical professionals may be present at certain times throughout the event weekend, they are not responsible for providing medical care to retreat participants. Attendees are responsible for contacting their home HTC, hematologist, or other appropriate medical provider for medical needs or guidance.

    The Western Pennsylvania Bleeding Disorders Foundation (WPBDF) and Eastern Pennsylvania Bleeding Disorders Foundation (EPBDF) expect attendees to follow the recommendations of their home HTC or hematologist regarding travel and to bring all medications, treatment supplies, and other medical items they may require during the retreat.

     

    Supervision of Minor Participants

    If I am bringing a minor to the YOU Matter! Women’s Retreat, I agree to be responsible for the supervision of the registered minor participant throughout the retreat. I understand that I may not leave the retreat premises without the minor unless another parent or legal guardian of the minor remains on the premises and assumes responsibility for the minor.

    If I cannot be located on the retreat premises and the minor requires immediate medical assistance, I understand and agree that emergency medical services may be contacted and, if necessary, an ambulance may transport the minor to the nearest appropriate medical facility.

     

    Participation Waiver

    I hereby freely, knowingly, and voluntarily agree to participate in the programs and activities conducted during the YOU Matter! Women’s Retreat.

    I hereby fully waive, release, and discharge the Western Pennsylvania Bleeding Disorders Foundation (WPBDF) and the Eastern Pennsylvania Bleeding Disorders Foundation (EPBDF), and their respective agents, employees, successors, and assigns, from any and all rights, claims, and actions arising now or in the future out of my participation in programs and activities during the YOU Matter! Women’s Retreat.

    If I am bringing a minor to the YOU Matter! Women’s Retreat, I freely, knowingly, and voluntarily consent to and give permission for the minor participant named in this registration form to participate in all programs and activities conducted during the YOU Matter! Women’s Retreat. I understand that the waiver and release above also applies to my participation in connection with the minor participant’s participation in the retreat.

    I further agree to indemnify and hold harmless WPBDF and EPBDF from any claims arising out of any injury or harm that I, or any minor participant for whom I am responsible, may cause to another individual during participation in programs and activities at the YOU Matter! Women’s Retreat.

  • Agreement for Additional Adult Participant(s)

    If you registered an additional participant who is 18 or older, we will email that participant a copy of these agreements to review and sign before the event.

  • Participant Acknowledgment

    By signing below, I acknowledge that I have read and understand the Participation Waiver, Medical Responsibility & Emergency Care provisions, Minor Supervision requirements, and policies outlined above. I agree to abide by these expectations and accept responsibility for managing my own medical needs and/or the medical needs of any minor participant for whom I am responsible, if applicable, in accordance with the recommendations and treatment plan provided by our healthcare providers while participating in the YOU Matter! Women’s Retreat.

  • Please add the date you completed this form*
     - -
    2 digit month, 2 digit day, 4 digit year
  • SECTION 9 — Registration Fee

  • Registration for the 2026 You Matter Women's Retreat is a non-refundable $25 fee. 

    If the registration fee or transportation costs will create a financial hardship, we offer a scholarship for the registration fee, and transportation assistance. By selecting Scholarship below, you will have the option to apply for the registration fee to be waived.

    Later in this form is the option to apply for transportation assistance in the form of a gas card.

  • I understand that my approved registration means that I will have a hotel room reserved for me/my family. One $25 non‐refundable registration fee* is required per family. If you do not receive my completed registration form and $25 fee by the registration deadline, Friday, October 16, my hotel room reservation may be released. I understand that this fee is non‐refundable.

  • The non-refundable $25 registration fee can be paid by check, money order, or credit card. How would you like to pay?*
  • Mailing instructions for check payments:

    Please make checks and money orders payable to WPBDF and mail to the following address:

    WPBDF
    Attn: YOU Matter! Women's Retreat
    433 State Avenue, Suite 4
    Beaver, PA 15009

    Payment must be received or postmarked by October 16, 2026.

  • Credit Card Payment

  • YOU Matter! Women's Retreat Registration Fee Payment by Credit Card

    To pay the $25 registration fee by credit card, enter your payment information below. If you are not ready to pay at this time, click SAVE to save your information. Payment must be received by October 16, 2026.

    After entering your payment information, click the Next button.

    Your registration will not be completed until you click the Submit button on the LAST page.

  • Credit Card Payment*

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    YOU Matter! Women's Retreat Registration Fee. Non-refundable
    YOU Matter! Women's Retreat Registration Fee

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    Credit Card

  • Scholarship

    Scholarships are available for those experiencing financial hardship.
  • If the $25 registration fee would create a hardship that would prevent you from attending the YOU Matter! Women’s Retreat, you may apply for a scholarship. Scholarship applicants must be in good standing with WPBDF and EPBDF, meaning they have not no-showed multiple events they registered for during the past 18 months (without a medical concern or illness), and they must also be in good standing with their home HTC, meaning they regularly attend their HTC appointments without last-minute cancellation or no-showing their appointments (without a medical concern or illness).

  • SECTION 10 — Transportation Assistance

    Scholarships are available for those experiencing financial hardship.
  • If transportation costs create a hardship that would prevent you from attending the YOU Matter! Women’s Retreat, you may qualify for Transportation Assistance.

    Mileage reimbursement is available in the form of a gas card for travel to and from the Hershey Lodge at the current IRS medical mileage rate of 23.5 cents per mile. If approved, a gas card will be provided at event check-in.

  • Do you need transportation assistance?*
  •  

    By selecting YES, you have indicated you need Travel Assistance. A confirmation email will be sent before the event with more details regarding the gas card you can expect to receive at event check-in.

     

    Please press the NEXT button to proceed

     

  • Submit Registration Application for the YOU Matter! Women's Retreat

    To review your answers now, click the Back button; to save your current answers and come back to finish or modify your form, click the Save button; otherwise, click the Submit button to submit your registration application. Your registration application will not be completed until you click the Submit button.

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