Adult Retreat

The adult retreat is for adults 20 years of age or older with a bleeding disorder and their significant other. Parents of someone with a bleeding disorder are also invited. You will learn something new and leave empowered to be a better advocate. Connect during fellowship, food, education, and FUN! Agenda.

This retreat is for consumer members in GHA’s service area. GHA’s service area is defined as Southern Illinois and Eastern Missouri.

GHA will reserve a Friday and Saturday room, unless otherwise stated. Complete the registration form below. The $30 non-refundable registration fee is due at the time of registration and helps cover conference materials. Questions call (314) 482-5973 or email info@gatewayhemophilia.org. Registration deadline is April 1.

April 29 – May 1, 2022

Location: Margaritaville, Lake Ozark MO

Adult Retreat Registration

By continuing, you agree that you are attending the Adult Retreat as a consumer.*
# of Adults Attending*
Name of person with the bleeding disorder*
You or your family's Bleeding Disorder: (check all that apply)*
Name of Adult #1 Attending*
DOB of Adult #1*
MM slash DD slash YYYY
Gender*
List any dietary restrictions or allergies for adult #1
Name of Adult #2 Attending (if applicable)
DOB of Adult #2 if applicable
MM slash DD slash YYYY
Gender
List any dietary restrictions or allergies for adult #2
Email Address*
Address*
Street Address Address Line 2 City State ZIP Code
Contact number with area code*
Are you employed by a Specialty Pharmacy or Manufacturer? GHA will not cover your hotel if you work for one of our industry partners.
Type of Room
Any other special accommodations or needs? Handicapped Accessible Room
What kind of insurance do you have? (Your answer is optional. Knowing this information allows us to be informed and better advocates for our community.)
I acknowledge that I am expected to attend the educational programming on Saturday and Sunday. If I am unable to attend I will let the executive director know immediately. If not, I understand I may be charged for the hotel room.*
PLEASE NOTE: The appropriate registration fee should be submitted as part of your registration, unless you are requesting a waiver. The non-refundable registration fee covers your hotel room, conference meals, and conference materials.
Registration Fee
- $30
- Asking for a waiver this year