EmpowerFest 2024
3-Day Event for People with Limb Loss/Limb Difference
Hollywood, Florida

June 7-9, 2024

Schedule:
Thursday, June 6, 4:00-7:00 pm - Badge and bag pick up
Thursday, June 6, 6:00-8:00 pm - Welcome Reception
Friday, June 7, 8:00 am-8:00 pm
Saturday, June 8, 8:00 am-8:00 pm
Sunday, June 9, 8:00 am-1:00 pm

Event fee: $50 per person
Event fee includes breakfast and lunch daily and Friday & Saturday night dinner.
Guests can include family members or supportive friends.

Hotel:
The Diplomat Beach Resort
3555 S Ocean Dr, Hollywood, FL 33019

Book your room online no later than May 15, 2024 to receive the discounted room rate of $140 per night, including taxes & fees. You may also call 1-855-689-2911 and mention Hanger Clinic’s EmpowerFest.

EmpowerYOUth
1-Day event for kids
June 8, 2024

Schedule:
Saturday, June 8, 9:00 am-4:00 pm

For more information, please email EmpowerFest@hanger.com.

Connecting People with Upper and Lower Limb Loss

Registration Type *

(3-Day) Attendee Registration ($50)

(1-Day) Kid's Day Registration - must be 17 or younger ($10)

Hanger Employee

Physical Therapist / Occupational Therapist / Medical Professional / Guest

Team Hanger Clinic

Discount Code

First Name *

Last Name *

Nickname (Different first name you'd like on your badge)

Credentials

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number *

Country *

Gender/Age Group *

Email Address *

T-Shirt Size (Unisex sizing) *

Is this your first time attending EmpowerFest? *

Yes

No

How did you hear about EmpowerFest? *

How did you hear about EmpowerFest?

Are you a person with lower limb loss? *

Yes

No

Are you a person with Rotationplasty? *

Yes

No

Please rate your mobility level from 1 to 5 stars: *

1-star: Limited mobility; 5-star: Extremely active

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Are you primarily using a wheelchair for mobility?

Yes

No

Are you bringing an electric wheelchair?

Yes

No

Do you need the hotel to provide a shower chair?

Yes

No

Are you a person with upper limb loss? *

Yes

No

How easy is it for you to use your upper limb prosthesis?

1-star: Extremely difficult; 5-star: Very easy

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Are you a Hanger Clinic patient? * 🛈

Yes

No

Are you bringing a guest? *

Yes

No

Select the box for each guest you will be bringing and make sure you fill out the guest information below. * 🛈

Guest #1 ($50)

Guest #2 ($50)

Guest #3 ($50)

Guest #4 ($50)

Select the box for each guest you will be bringing and make sure you fill out the guest information below. * 🛈

Guest #1

Guest #2

Guest #3

Guest #4

Select how many guests you will be bringing and ensure you have filled out the guest information below. (Please note the $10 registration fee covers the child attendee and one parent/guardian. Each additional guest is $10.) * 🛈

Guest Information:

	First Name	Last Name	City, State	Shirt size	Email	Relationship to attendee
Guest #1	First Name	Last Name	City, State	Shirt size	Email	Relationship to attendee
Guest #2	First Name	Last Name	City, State	Shirt size	Email	Relationship to attendee
Guest #3	First Name	Last Name	City, State	Shirt size	Email	Relationship to attendee
Guest #4	First Name	Last Name	City, State	Shirt size	Email	Relationship to attendee

Are you staying at The Diplomat Beach Resort? *

Yes, I am booking my hotel room at The Diplomat Beach Resort.

No, I will commute to the event.

Are you staying at The Diplomat Beach Resort? *

Yes, I request Hanger event staff to book my hotel room.

Yes, I will book my own hotel room.

No, I will commute to the event.

Arrival Date * +

Departure Date * +

Please select the activities that you are interested in participating in (you may select multiple activities): *

You selected that you are interested in adaptive scuba diving at EmpowerFest. We are hosting a mini lesson in the pool during EmpowerFest on Saturday. There is also an opportunity to go scuba diving in the ocean on Monday, after EmpowerFest, with a small group. This is not an EmpowerFest sponsored event, but you can stay at the Diplomat hotel at the EmpowerFest discounted rate through Tuesday night. You must indicate below if you are interested, and a representative will reach out to you with more information on cost and more details: *

Yes, I am interested in learning more about an adaptive scuba class on Monday, June 10

No, I am not interested in participating

The Hanger Foundation is hosting a 1K/5K fun run/walk on Saturday, free of charge for EmpowerFest attendees. All mobility levels are welcome to participate. Please indicate if you are interested in participating and more information will be emailed to you regarding the event. *

Yes, I am interested in participating in the 1K/5K walk/run.

No, I am not interested in participating in the 1K/5K walk/run.

Would you like an assigned run/walk "buddy" to assist and cheer you on your way to the finish line? *

Yes, please

No, thank you

Would you like an assigned run/walk "buddy" to assist and cheer you on your way to the finish line? *

Yes, please

No, thank you

Please fill in the Foundation 1K/5K Participant Information:

	First Name	Last Name	Age	Email
Participant #1	First Name	Last Name	Age	Email
Participant #2	First Name	Last Name	Age	Email
Participant #3	First Name	Last Name	Age	Email
Participant #4	First Name	Last Name	Age	Email
Participant #5	First Name	Last Name	Age	Email

(Optional) Please share any information about your amputation level and mobility/activity/personal goals that you have for this event.

Additional Requests, Dietary Needs, Comments, or Questions: