CJD Foundation Family Conference Registration Form

 

2018 CJD Foundation Family Conference

July 13th to 15th
At the Washington Court Hotel
Advocacy Day Monday July 16

Registration is $215 per person.

Conference Attendee
Check this box if you will be attending the conference.
Attendee Information
Enter the complete telephone number. Please do not include a "1-" before the area code.

If you'd like us to include a photo of your loved one on our conference banner, please email it in a JPG format to help@cjdfoundation.org by June 26, 2017.
* Not necessary if you submitted a photo last year.

I WILL ATTEND THE FOLLOWING
Please check yes or no for EACH meal or event. (Friday sessions begin at 12:45 p.m.)
Friday, July 13
(Choose either Sporadic or Genetic)
*only for families affected by a genetic prion disease (Choose either Sporadic or Genetic)
Saturday, July 14
Sunday, July 15
Monday, July 16
*Meetings are scheduled between 8 a.m. and 4 p.m.
Event Sponsorships
Donation
I cannot participate but would like to contribute to the event. (If you are attending and you would like to make an additional contribution enter it here and it will be added to your total.)
$
$
This field is calculated automatically.
Billing Information
Enter the complete telephone number. Please do not include a "1-" before the area code.