April 20-22, 2018
Ann Arbor Marriott Ypsilanti at Eagle Crest,
1275 S Huron St, Ypsilanti, MI 48197
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ROOM NOT PROVIDED - Friday, Saturday and Sunday Day ONLY registration, includes programs & meals.$30 per person. Four years old and under, no charge. Maximum $150 per family.
Meal value $200 per person.
Please continue to register without payment. You will have an opportunity to complete the financial assistance form once this form is submitted.
Please continue to register and an HFM staff member will contact you with more information.
Thank you for your interest in attending Springfest, however this event is intended for individuals with bleeding disorders and their immediate family members only. If you should have questions, please contact HFM at: 734.544.0015
1st YOUNG CHILD (0-4 years) INFORMATION
2nd YOUNG CHILD (0-4 years) INFORMATION
3rd YOUNG CHILD (0-4 years) INFORMATION
4th YOUNG CHILD (0-4 years) INFORMATION
1st YOUTH (5 - 12 years) INFORMATION
2nd YOUTH (5 - 12 years) INFORMATION
3rd YOUTH (5 - 12 years) INFORMATION
4th YOUTH (5 - 12 years) INFORMATION
1st TEEN (13 - 17 years) INFORMATION
2nd TEEN (13 - 17 years) INFORMATION
3rd TEEN (13 - 17 years) INFORMATION
4th TEEN (13 - 17 years) INFORMATION
Section A:By signing below, I give HFM (Hemophilia Foundation of Michigan) and/or its assignees all rights, title, and interest in whatever photographs and/or video footage in which I/my minor child may appear, for the purposes outlined below, without compensation to me.
I further authorize the use of my/my minor child’s statements and testimonials, narration of services provided to me, narration of service outcomes, articles, stories, or other such literary, artistic, or educational value, and consent to the copyright and fair use of same, in accordance with all applicable trademark and copyright laws.
I further release HFM, its Board, its officers and representatives from any and all claims of any nature arising from any medium and/or publication.
Section B:This authorization and assignment is intended for, but not limited to, the publication of promotional documents, pamphlets, brochures, news articles, charitable drives, website use, social media, agency advertising, television, and other such marketing materials.
I therefore give the HFM (Hemophilia Foundation of Michigan) the absolute right and permission with respect to items listed in Section A to use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other information, photographs, video, etc. in any medium now or hereafter known, and for any purpose whatsoever, including but not limited to illustration, promotion or advertising.
Section C:I hereby affirm that I am of full age and have the right to contract in my own name or on behalf of my minor child. I have read the foregoing and fully understand the contents hereof. This release shall not expire and will be binding upon me and my heirs, legal representatives, and assignees.
I understand that I may revoke this consent at any time by sending written notice of such request to the attention of HFM Director of Finance & Operations: Sharon S. Ceci, 1921 West Michigan Avenue, Ypsilanti, MI 48197
I understand that my minor child will be transported by HFM designated staff and/or volunteers OR a chartered bus service to and/from the Lincoln School District.
I hereby give permission and release/discharge the Hemophilia Foundation of Michigan, its officers, agents, and employees from any and all claims or liability for personal injury or property damage that may arise from my child being transported to and/or from the SpringFest activities. In the event that my child is injured while being transported and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed medical practitioner.
In the event treatment is called for, which a physician and/or hospital personnel refuse to administer without my consent, I hereby authorize the lead adult of the group to give such consent for us if I cannot be reached by telephone at one of the numbers on file or if, because of an emergency, there is not time or opportunity to make a telephone call. In the event it becomes necessary for that person to give consent for me, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of consent. I also acknowledge that I will be ultimately responsible for the cost of any medical care, should the cost of that care not be covered or reimbursed by the health insurance carrier.
Questions? We are here to help! Please feel free to contact the HFM Office at