FAMILY DIABETES EDUCATION WEEKEND. MIDWAY HOTEL 3100 Dodge Street, Highway 20 in DUBUQUE, IOWA reserved so mention Camp Hertko Hollow Diabetes weekend …
FAMILY DIABETES EDUCATION WEEKEND
MIDWAY HOTEL -3100 Dodge Street, Highway 20 in
DUBUQUE, IOWA
November 1-2, 2008
9 am Saturday thru 11 am Sunday
This is an ideal opportunity for families with young children and newly
diagnosed youth of all ages It gives parents a chance to talk with other
parents for support The kids will have fun with their peers and
counselors, and know that Mom or Dad are nearby Grandparents and close
friends are encouraged to attend
The program is presented Kris Tiernan, ARNP, from Medical Associates along
with a nurse, dietitian, and physician, who will be available to any answer
all of your questions about diabetes Come learn from the experts Camp
Hertko Hollow counselors will present a panel and discuss their experiences
about growing up with diabetes There will also be vendor displays about
diabetes supplies, TrialNet Screening from University of Iowa, and more A
support meeting will be held on Sunday morning
Families must make their own reservations if you wish to stay overnight at
the hotel Call the Best Western Midway Hotel at 800-336-4392 View Web
site for photos and
details: wwwbestwesterniowacom A block of rooms
have been reserved - so mention Camp Hertko Hollow Diabetes weekend
Cost for the seminar: 15 per adult and 5 for children under age 12 plus
the 25 non-refundable deposit per family The price includes meals plus
snacks What a great deal Parents are responsible to bring all
medications, including insulin and supplies Registrations are accepted on
a first come, first serve basis So apply before the October 24th
deadline Directions to the hotel and other details will be sent prior to
the weekend
Any questions? E-Mail: CampHertkoHollow@aolcom or call 888-437-8652
toll free
REGISTRATION FORM:
Parents names _____________________________________________ E-Mail
address: _______________________
Address: ______________________________ Home Phone:
__________ Cell phone: ______________
Town: _________________________ State _____ Zip ___________ Work
phone: _________________
Is your family planning to stay overnight at the Midway Hotel? YES NO
Child with diabetes_________________________ Birthdate: ____________ Age
___ Age when diagnosed ______
Names Ages of siblings or others
attending:
1_____________________ M or F _____years old 2
____________________ M or F ____years old
3_____________________ M or F _____years old 4
____________________ M or F ____years old
Other adults attending:
______________________ M or F grandparent, babysitter, other:
____________________
______________________ M or F grandparent, other: ________________
Explain any special dietary requirements for all participants allergies,
celiac diet, etc
____________________________________________________________________________
_________________
____________________________________________________________________________
__________
Amount enclosed: _________ payable to Camp Hertko Hollow Enclose
check with your registration form or call 515-471-8523 to use a credit
card Call if you wish to FAX the form
Mail to: Vivian Murray, Camp Hertko Hollow, 101 Locust Street, Des Moines,
IA 50309
Source:camphertkohollow.com
