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Proteus Syndrome Foundation Family Conference

September 18 - 19


DoubleTree by Hilton

8120 Wisconsin Avenue

Bethesda, MD 20814

(301) 652-2000
Presented by

The Proteus Syndrome Foundation

www.proteus-syndrome.org


DETAILS:

You can register by mail and pay by check or money order.



Mail: Fill out the attached form and mail the registration section and your payment to:

Proteus Syndrome Foundation

c/o Kim Hoag

4915 Dry Stone Dr.

Colorado Springs, CO 80923 USA

OR

To pay by credit card go to www.proteus-syndrome.org and follow the conference links.


Please have registration forms to us by Monday, August 24, 2015.

  • If you cannot get your form back by August 24, please contact Kim Hoag to let her know you will be attending.

  • Phone: 719-660-1346

  • Email: kim@cheersliquormart.com

You will pick up your conference packet when you check into the conference

on Thursday night or Friday morning depending on when you arrive.


LODGING:
YOU MUST RESERVE YOUR ROOM NO LATER THAN MONDAY AUGUST 24, 2015 TO RECEIVE THE DISCOUNTED ROOM RATE. Please follow this link to register for your room at the reduced rate of $119.00 per night + taxes

The web page address is: http://doubletree.hilton.com/en/dt/groups/personalized/W/WASBHDT-PS9-20150916/index.jhtml?WT.mc_id=POG



Group Name:

PROTEUS SYNDROME FOUNDATION

Group Code:

PS9

Check-in:

16-SEP-2015

Check-out:

20-SEP-2015

Hotel Name:

DoubleTree by Hilton Hotel Bethesda - Washington DC

Hotel Address:

8120 Wisconsin Ave. Bethesda, Maryland 20814-3624

Phone Number:

301-664-7343













Hotel Guest Room Rates: Single/Double Rates are $119.00 plus state & local taxes (currently 13%).

The DoubleTree by Hilton has a full-service restaurant, swimming pool, fitness center & laundry facilities. Check in is 3:00pm and a 12:00 noon checkout.


CHILD CARE AND ACTIVITIES:
All-day childcare with age appropriate activities will be offered for children during the Friday/Saturday conference. Please bring any ‘special toys’ or blankets etc., which your children may find comforting.

CONFERENCE FEES:

The cost of the conference which includes registration, meals and conference materials is:



Must be paid in US dollars.
$95.00 per individual

$30.00 per child 12 and under - includes child care and meals same as individuals.



CONFERENCE SCHEDULE:

Thursday, Sept 17 6 - 8 PM Registration; Family Meet-And-Greet, Hamburgers,

Hot Dogs & Trimmings (included in conference fees)

Friday, Sept. 18 7 - 8 AM Breakfast on your own; Registration

8 AM - 5 PM All-day Meeting/Speakers/Break Out Sessions

Morning Snack & Lunch Included

Dinner on your own

Saturday, Sept. 19 9 AM - 5 PM Breakfast on your own. All-day Meeting/Speakers/Break Out Session/Morning Snacks & Lunch Included

6 - 9 PM Dinner in hotel (Included in conference fees)

Depart on Sunday, September 20, breakfast on your own.


There will be breakout group sessions with the presenters/doctors during the conference on Friday/Saturday.

You will be able to register for the sessions you wish to attend when you arrive at the conference.


Teleconferencing: We are working on the possibility of offering teleconferencing to those who are unable to attend. Details to follow.


Return Registration form by August 24, 2015.

Please contact Kim Hoag if you have questions:



kim@cheersliquormart.com or 719-660-1346

REGISTRATION FORM



Please fill out both pages of this registration form

and return it by Monday, August 24 to:

Email: kim@cheersliquormart.com

or

Proteus Syndrome Foundation

c/o Kim Hoag

4915 Dry Stone Dr., Colorado Springs, CO 80923 USA

Name: ________________________________________

Address: _______________________________________________________________________________________

_______________________________________________________________________________________________

Phone: _________________________________ Email: ______________________________


Name of Child or Adult family member with Proteus syndrome_________________________________________

I give permission to print our name, address and phone # in the packet of conference materials Yes __ No___

Do you request financial assistance Yes ______ No _______ (if yes you will be contacted by the foundation)
Registration Fees: (Registration fees include, Friday lunch, Saturday breakfast, lunch & snacks during conference, dinner reception, daycare and conference materials).

Pre-registration for meeting helps us estimate room size and catering needs.

Payment must be made in US dollars.

Make checks or money orders payable to The Proteus Syndrome Foundation
$95.00 per individual $____________
$30.00 per child 12 and under $____________


Scholarship Fund Donation: Your contribution to this fund helps offset

registration fees for other participants and is greatly appreciated. $____________thank you



Total Amount Enclosed $____________


Please RSVP on ALL items below.

The Friday & Saturday conference includes lunch and one snack break.



If you will not be having lunch at the conference please note that below.
List the names of those who will be attending the conference. Please list ages of all children. Please write Y (yes) or N (no) if each person is attending Thursday, Friday & Saturday.

Name Age Day’s Attending Conference

Thursday dinner Friday Saturday



______________________ ___ _____ ______ ______
______________________ ___ _____ ______ ______
______________________ ___ _____ ______ ______
______________________ ____ _____ ______ ______

______________________ ____ _____ ______ ______

______________________ ____ _____ ______ ______

SATURDAY EVENING PSF DINNER
The Proteus Syndrome Foundation invites you to attend dinner Saturday evening

6:00pm – 9:00pm.


Once we receive your registration form you will be contacted for your evening food choices.


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