2024 Community Night: Incredible Mo's

1355 Silver Lake Crossings Blvd, Grawn, MI 49637

Traverse City Community Night

November 1, 2024 6:30-9:00 PM

We are so glad you are joining us for our annual Traverse City Community Night!

Please register below.
Number of Adults*
Name*

First NameLast Name
Michigan Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Email*
example@example.com
Phone Number*
2nd Adult*

First NameLast Name
3rd Adult*

First NameLast Name
4th Adult*

First NameLast Name
Number of Children*
First Child*

First NameLast Name
Second Child*

First NameLast Name
Third Child*

First NameLast Name
Fourth Child*

First NameLast Name
Fifth Child*

First NameLast Name
Sixth Child*

First NameLast Name
Seventh Child*

First NameLast Name
Special dietary needs/allergies (We will do our best to accommodate):*

No special dietary needsGluten FreeVegetarianVeganDairy FreeOther
Photo and Video Release

Why We Ask:

It is HFM’s pleasure to host community members at various events throughout the year. By documenting these events through photo and/or video we hope to maintain a historical record of community activities, share photos for future events or activities, and promote fundraising efforts that support HFM events and services. It is a joy to reminisce when looking through photos, we hope to preserve community memories and moments.
Please select one:*

I consent to and authorize the use and reproduction, in print or electronic format by the Hemophilia Foundation of Michigan (HFM), or anyone authorized by HFM, of any and all photographs or video of me/my child(ren) which have been taken for this event, for any publicity, without compensation. I understand that all images and quotations of/by me/my child(ren)—electronic, print, and recordings—are owned by HFM which may publish or use them in any professional manner, including, but not limited to: print publications, websites, social media, and broadcast media. I acknowledge that I am 18 years of age or older and have read and understood the terms of this release.I do not authorize or permit the Hemophilia Foundation of Michigan (HFM) or its authorized agent to use photos and/or video of me/my child(ren).
Signature*

Clear
You can make a difference!

Please consider what is a meaningful, but comfortable amount for you to contribute toward your participation.
HFM relies on donations from community members and supporters to provide programs like Community Nights and other services to all members of the Michigan bleeding disorders community. Please consider making a donation to assist those in need and to assist HFM in continuing to offer programs and services. Your contribution will provide education, meals, transportation assistance, and endless opportunities for connection between Michigan community members.

$100 Community Night Champion$50 Bowling Buddy$25 Pizza Partner$10 Arcade Ally$0 I am unable to contribute at this timeOther
Calculation

Should be Empty:

You can make a difference!