Colorado Juvenile Arthritis Family Day

Saturday, October 26, 2013 from 10:00 am - 2:00 pm

Check-in begins at 9:30 am

National Jewish Health
1400 Jackson St.
Denver, CO 80206

JA Family Day is an event for children and teens with rheumatic conditions, and their families. Join us to learn about arthritis, network with families who have similar concerns, and enjoy a day of fun activities!

*Kids will be swimming-- don't forget to wear your swimsuits!*

Registration is required by October 11, 2013.

In order for us to prepare for the dayís activities, please register all adults and children that will be attending. Include names, ages of children, and if applicable, the specific JA diagnosis. If you have questions about the registration process please contact Pam Snow at 888.391.9389 ext. 6555

* required information
Registration 
Registration Information
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Phone:*
Email:*
Name 1 (First & Last):
Name 1 Age:
1- Type of Arthritis:
Name 2 (First & Last):
Name 2 Age:
2- Type of Arthritis:
Name 3 (First & Last):
Name 3 Age:
3- Type of Arthritis:
Name 4 (First & Last):
Name 4 Age:
4- Type of Arthritis:
Name 5 (First & Last):
Name 5 Age:
5- Type of Arthritis:
Name 6 (First & Last):
Name 6 Age:
6- Type of Arthritis:
Name 7 (First & Last):
Name 7 Age:
7- Type of Arthritis:
Fees
$10.00 Family Registration
General Registration
Donation

Your donation will help the Arthritis Foundation serve the estimated 300,000 children who live with arthritis in the United States. Please consider making an additional donation here.
Amount:$

A limited number of scholarships are available. If you need one please contact Pam Snow at 888.391.9389, opt 2, ext 6555.

WAIVER: 1. In consideration of this application to participate in the Arthritis Foundationís JA Program being accepted, I hereby waive and forever discharge the sponsors, organizers, affiliates as well as their agents and employees from any and all claims that may occur as a result of my familyís participation. 2. I hereby grant the Arthritis Foundation specific permission to reproduce, publish, circulate, copyright, or otherwise use any and all photographs and/or videotape of me and/or my family taken at this JA Program for use by the Arthritis Foundation. 3. I understand that the Arthritis Foundation and the facility retain the right to enforce the rules of the JA Program and the facility and if necessary send home anyone infringing on the rights or safety of others.4. I understand that the Arthritis Foundation, JA Program, and the facility DO NOT carry accident insurance for the child or adult participants. I will be held responsible for providing my own insurance/medical coverage, if need be, for myself and all members of my family.



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