Self-Care for Caregivers

Friday, June 21, 2024
6:00 PM 7:00 PM

Comfort Care Center 340 E Coronado Rd #100 Phoenix, AZ, 85004 United States (map)

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Are you the parent or a caregiver to a child battling cancer or another life-threatening disease? Join us for a night of yoga, wellness, and relaxation!

Please fill out the form below to register

How many will be attending?

This event is for caregivers only.

Parent/Caregiver's Name

First Name

Last Name

Parent/Caregiver's Email

Parent/Caregiver's Cell Phone

(###)

###

####

Second Parent/Caregiver's Name (If Attending)

First Name

Last Name

Warrior's Name

First Name

Last Name

How did you hear about this event?

Additional Comments

SMS Opt-In

By checking the box, I give permission to be contacted about Amanda Hope Rainbow Angels by SMS text at my residential or cellular number, dialed manually or by autodialer (consent to be contacted is not a condition to participate). I consent to be contacted even if my phone number appears on an Amanda Hope Rainbow Angels Do Not Call List, a State or National Do Not Call Registry, or any other Do Not Contact List.

Email Opt-In

By checking the box, I give permission to be contacted about Amanda Hope Rainbow Angels by email at my provided email address (consent to be contacted is not a condition to participate). I consent to be contacted even if my email address appears on an Amanda Hope Rainbow Angels Do Not Email List or any other Do Not Contact List.

Media Consent

By checking this box, I give my permission for Amanda Hope Rainbow Angels and/or its representatives to use artwork, photographs and/or letters that I provide of my child, my family, and/or myself in publications, slides, videotapes, motion pictures and/or on the Internet. In addition, I hereby give my permission for Amanda Hope Rainbow Angels and/or its representatives to photograph, audio tape record, and/or videotape my child or myself and to use our names, these images or voice recordings in publications, slides, videotapes, motion pictures and/or on the internet. I understand these visual images or voice recordings may be used to inform families, volunteers, donors, the media and general public about Amanda Hope Rainbow Angels programs, services or events. I gladly give this authorization to support the efforts of Amanda Hope Rainbow Angels. I understand this authorization shall continue until terminated in writing. Providing consent is not a requirement in order to participate in Amanda Hope Rainbow Angels programs.

Attendance Policy

By checking this box, I agree to comply with the written policy below. By completing this form, I am registering for this Amanda Hope Rainbow Angels event. If at any point, I am no longer able to attend the event, I will immediately notify Amanda Hope Rainbow Angels’ Event Coordinator, Morgan Webre, via email (morgan@amandahope.org) or phone (602-612-5372). If I do not notify the organization before the event and do not show up at the event, I acknowledge that I will not be allowed to attend the next event. If the behavior continues, I acknowledge that I will be evaluated on an individual basis and may have all event attendance privileges revoked. If there is a medical emergency that causes me/my family to miss an event and I am unable to notify the Amanda Hope team beforehand, I agree to advise the Amanda Hope team at the next available opportunity.

Rules of Conduct

By checking this box, I agree to conduct myself in a polite and respectful manner towards all other attendees, staff, volunteers, and any other individuals when attending an Amanda Hope Rainbow Angels event consistent with core values of the organization.

Posted In: Comfort and Care
Tagged: wellness

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