Women’s Retreat

GHA will host a Women’s Retreat for women 18 and older that are caregivers of a person with a bleeding disorder or have a bleeding disorder themselves. Attendees must be members and live in the service area of either Gateway Hemophilia Association or Midwest Hemophilia Association. The retreat is March 22 – 24, 2019 at The Lodge of Four Seasons, Lake Ozark, MO. The focus of the conference will be education, personal growth and networking. Sessions will focus on bleeding disorders, treatment options and most importantly relaxation!

There is a non-refundable $20 registration fee. The deadline for registration and payment is March 1, 2019!

Women's Retreat Registration

Last Name*
First Name*
Date of Birth*
Street Address*
City*
State*
Zip Code*
Email*
Phone Number*
Emergency Contact Name*
Emergency Contact Phone Number*
Emergency Contact Relation*
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.)*
Type of Community Member (Please check all that apply):**
If selecting more than one choice, hold the Ctrl button while selecting.
Please Indicate Type of Bleeding Disorder (if you are a consumer or caregiver):**
Chapter Affiliation:
Are you attending the reception at 6:00 p.m. on Friday, March 22?*
List any dietary needs or special requests.
Are you requesting a hotel room on Friday, March 22?*
A hotel will be provided for you on Saturday night, unless you tell us otherwise.
To serve more women we are asking if you wouldn't mind sharing a room. If so, please list the name of the person you would share a room with below.
What type of room are you requesting, if it's available?