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2022 SBAGNE Holiday Party Registration
Saturday, December 3rd (Maine)
Sunday, December 4th (Massachusetts)
Registration Deadline Friday, November 18, 2022
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Cell Phone
*
Total Number in Party
*
Please enter how many people will be attending from your party
Attending which party
*
Please select which party you will be attending
Maine (Saturday, Dec 3rd)
Massachusetts (Sunday, Dec 4th)
First and Last Name of Person with Spina Bifida
Birthdate of person with Spina Bifida
(mm/dd/yyyy)
Name, age and gender of EVERY child aged 13 and under attending the party
Dietary Restrictions / Allergies
Does anyone in your party require/have dietary restrictions or allergies? Please describe below.
Dietary restrictions or allergies?
Photo Release
I agree that SBAGNE may use photos of me and/or my minor children from Conference for website, email. Annual Report and social media purposes.
Photo Release
*
Yes
No