Adding to Your Toolbox-Care Partner Strategy Conference
September 25, 8 am to 4 pm, Lancaster Alliance Church, Lancaster PA
Attendee Information
Please fill name and contact information of attendees. Complete this form for each person attending.
Your Name
First Name
Last Name
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
I'm attending as:
A care partner of someone who lives with dementia
A person living with dementia
Dementia Friendly Lancaster Volunteer (free admission, need to purchase lunch)
DFL/FW Partner (free admission, need to purchase lunch)
Sponsoring Organization registrant (Organization name must match a confirmed sponsor)
Other
If admission is part of a sponsorship, list Sponsoring Organization here:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
List any dietary restrictions here:
Indicate your level of interest for afternoon workshops:
Not Interested
Somewhat Interested
Interested
Very Interested
Mobility and Approach Strategies
Communication
Preserving Dignity
Elder Law and Aging Services
Dementia and the Five Senses
Simulated Dementia Experience
Late Stage and End-of-Life
Tactile learning for those living with dementia (Hands on Skills)
Real Life Stories and experiences shared by a couple, care partner and someone living with dementia
My Products
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Full-day conference admission
Admission includes morning sessions, lunch, and afternoon sessions.
$
75.00
Half-day morning session, 8 am to 12 pm
Keynote session, educational session and lunch at noon.
$
45.00
Half-day afternoon session, 12 pm to 4 pm
Lunch at noon, and afternoon workshops. Choose between several options of workshops according to your needs and interests (see below).
$
45.00
Lunch for ForgeWorks or DFL volunteers/partners
$
10.00
Quantity
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Volunteer/Partner Conference Admission
Complete for either full or a half day participation
$
Free
Quantity
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2
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