The A-Games Luncheon Signup

THE A-GAMES LUNCHEON ONLY SIGNUP

Sign up for the A-Games luncheon only here! Space is limited; we will accept sign-ups on a SPACE AVAILABLE BASIS and will contact those people who are NOT accepted.

(If you wish to sign up for the full A-Games experience, including swimming instruction, click here)


Honorific:	Mr. \| Ms. \| Dr.
Name:
Address 1:
Address 2:
City:
US State:
Zip Code:

Email Address: (user@domain.com format)
Phone Number: (Include your area code!)
Year of Birth:
Gender:	Male Female

Which Luncheon are you interested in?
Park Place Apartments, Denver, Colo. (November 8) Shimon and Sara Birnbaum JCC, Bridgewater, N.J. (postponed)

What kind(s) of arthritis do you have? Spondylarthropathies includes ankylosing spondylitis, psoriatic arthritis, and Reiter's syndrome.	Yes, osteoarthritis Yes, fibromyalgia Yes, rheumatoid arthritis Yes, gout Yes, spondylarthropathies Yes, juvenile arthritis Yes, juvenile rheumatoid arthritis (JRA) Yes, lupus Yes, (don't know type)

Are you currently a full CreakyJoints member?	Yes No

By enrolling for the A-Games or the luncheon, I hereby grant permission to CreakyJoints, Inc. or its designee to use now or at any time in the future, my name, photograph, likeness, and/or videotaped image for educational, advertising, or publicity purposes pertaining to the mission of CreakyJoints. I understand that I will not receive compensation or royalties now or in the future for the use of my likeness. I hereby give permission to CreakyJoints to post my name and/or photograph on the CreakyJoints web site.
(That is, "We're going to be taking photos and video at the A-Games so that we can publicize future A-Games events. Signing up means you're okay with this. Okay?")