Group Registration for Real Voices – Real Choices 2022

This form is intended only for group registration. For individual registration, please visit this link.
Please make sure to scroll completely to the bottom of the attendee information form that will appear when you click "Add Attendee." Please complete all questions. You can then add multiple attendees to your group registration by clicking the "Add Attendee" button again. As you add each group attendee, they will appear in the list below.
Attendee Name Actions
 
Price: $0.00

Organization Information

Name(Required)
Address(Required)
Conference Agreement(Required)
You must agree to these terms for your registration to be complete.

General Terms
To the fullest extent permitted by law, I/we indemnify and hold harmless, the Missouri Department of Mental Health, Missouri Mental Health Foundation, Margaritaville Lake Resort and their directors, officers, consultants, agents, employees and volunteers from and against all claims, damages, losses and expenses, including but not limited to attorney's fees and court costs, arising out of or resulting from my participation in this event, including damage, loss or expense is attributable to bodily injury, sickness, disease or death, or personal injury, or to injury to or destruction of tangible property or to others involved in the event.

Event Photography
I agree to the production of photographs, recordings, videotapes, or other multimedia projects developed by the Missouri Department of Mental Health and/or, the Missouri Mental Health Foundation, which may include being photographed, recorded, videotaped, or otherwise depicted in such multimedia information. I’ve been informed that these multimedia projects are being developed to provide an opportunity to educate and inform people about the activities of the Missouri Department of Mental Health and/or the Missouri Mental Health Foundation.  I authorize the Missouri Department of Mental Health and/or the Missouri Mental Health Foundation to use any and all of the multimedia information in which I appear and/or are heard without limitation. I acknowledge that the Missouri Department of Mental Health and/or the Missouri Mental Health Foundation will be for all purposes the owner of all rights to the media in which I appear and/or am heard. I agree to hold harmless the Missouri Department of Mental Health, and/or the Missouri Mental Health Foundation, and all their agencies, affiliates, employees, volunteers, agents, successors and/or assigns, against any liability, loss or damage, including attorney’s fees, caused by or arising from my appearance in any photograph, record, videotape, or other multimedia information.

I acknowledge that I have not given any other person or organization the exclusive right to use my photograph or any other information about me.

Medical Information

NURSE’S STATION – ON-SITE FIRST AID

Basic First Aid and Assessment, WITHOUT MEDICATION ASSISTANCE, will be available during conference hours. The Basic First Aid area will not provide over-the-counter medications such as Tylenol, Ibuprofen, topical creams, etc. You will be responsible for these needs.

  • ◦ If medical and assistive devices are needed, you are expected to bring them to the conference (for example wheelchair, walker, etc.)
  • ◦ Urinary Incontinence Supplies – If you have problems with wetting the bed, you will need to bring a waterproof mattress pad.
  • ◦ If needed, you are expected to have a caretaker assist you with your needs while attending the conference (for example transfers).
  • Registration Payment

    Billing Address(Required)

    Ready to submit your information? Please click the Submit button below only once. You will see a confirmation page once your registration is processed and an email will be sent to the email entered above.

    Registration will appear on your credit card statement as MMHF / Stripe.