New England Education Day & Youth Forum

Saturday November 2nd 2013

Holiday Inn Portsmouth New Hampshire

10 am to 3 pm

***Early Bird Special *** $20.00/person

Mail: Postmark by 10/15//2013 or online www.hdsa.org/need Submit by 10/15//2013

Regular registration: $25.00/person

Mail: Postmark by 10/25/2013 online. www.hdsa.org/need Submit by 10/25/2013

Sorry, no registrations accepted at door

Registration includes: Morning coffee, buffet lunch, and free parking at hotel.
Directions and Accommodations: www.holidayinn.com 603-431-8000

Online Registration . www.hdsa.org/need
Registration by mail: Fill out information below and mail to
HDSA New England Regional Office 6 Boston Road, Suite 203a Chelmsford, MA 01824

For more information, contact:
Virginia Goolkasian Phone: (888) 554-8102 Ex:13 FAX: (978) 256-0812 Email: vgoolkasian@hdsa.org


Schedule of Speakers and Topics
9:00 a.m. Registration with Coffee
10:00 a.m. Welcome Comments
10:15 a.m. "Clinical Trials and Research", Dr. H. Diana Rosas, MD Researcher and Neurologist MGH
11:00 a.m. "Advocacy: Getting your Representatives to Listen: Attorney Stephen Roche
12:00  Lunch with Jim Pollard
1:00 p.m. "Ask the Doc" Dr. Samuel Frank, Associate Professor of Neurology and Co-Director of Neurology
Resident education at Boston Medical Center and Boston University
2:00 p.m. " Assistive Technology apps on ipad", Rachael Licker M.S. CCC-SLP
2:30 p.m. Evaluations and Goodbyes

Youth Forum

This year's education day will include a session from 10 am to 3 pm for youth between the ages of 12 and 30.
The Youth Forum will be led by two Massachusetts board members Seth Rotberg who is the NYA president and regional social worker Karen Baker, LICSW.
They will provide a warm and supportive environment where the attendees can learn more about HD, HDSA, NYA, share experiences and enjoy fun activities.
Many youth who have attended the national youth alliance at our annual national convention have developed strong and dedicated friendships that continue year round.
The youth forum will meet in a separate meeting room at the Holiday Inn but join the education conference attendees for lunch.


YOUTH FORUM REGISTRATION

There is no fee for youth forum attendees but they must register
Children ages 12-18 must have their parents register them by contacting Karen Baker.
Anyone ages 19-30 may contact Karen and register themselves.
Please note that only those who have contacted Karen Baker by Oct 25th to register
will be allowed into the Youth Forum and we cannot make any exceptions.
Karen Baker can be reached at kbaker@hdsa.org or 508-446-7705.

 

Registration Form
 

Name_____________________________________
 

Address___________________________________
 

_________________________________________
 

Phone or email_____________________________
 

Additional name(s): (Use separate sheet if needed.) _________________________________________
 

Method of Payment:
Check made out to HDSA: ____
Bill my: ___American Express ___Visa
___ Master Card ___ Discover
 

CC#: ____________________________________
 

Expiration: ______________ CVV #___________
 

_________________________________________
Print name on above line as it appears on card
 

_________________________________________
Cardholder’s Signature
 

 

I, the undersigned, agree to indemnify and hold harmless the Huntington’s Disease Society of America (HDSA) from all cost,
expense and liability arising out of my or my child’s participation in this event to benefit HDSA.
I do hereby waive all claims for damage or loss to me or my child’s person or property which may have caused by any act,
by HDSA, its officers, agents, volunteers, or employees arising directly or indirectly from my or my child’s participation in this event;
and hereby assume liability for any loss or damage or other liability from such event.

 

_________________________________________
Signature

HDSA Thanks Lundbeck Pharmaceuticals for their sponsorship for this event.