SPA DAY REGISTRATION FORM

Veteran Spouse Appreciation Spa Day

Relax and connect with other Caregivers in the community

Sept. 23, 2017
11:30-2:30pm
Church of the Open Door
43275 Telegraph Rd, Elyria, OH 44035

* Indicates required field

Name *

First

Last

Email *

Phone Number *

ADDRESS *

CITY *

ZIP *

WHAT IS YOUR AGE *

In which branch of the military did your Veteran serve? *

Choose Any *

PTSD TBI Loss of Limb Other

WILL YOU NEED CHILD CARE *

YES NO

If yes, how many children will be attending with you?

NAME *

AGE *

Allergies

We will be providing your child with snacks/lunch and activities. Please let us know if your child has any food allergies or other concerns we should be aware of.

Comment *

About Hearts of Patriots
When Veterans return suffering from PTSD and/or TBI, their transition into civilian life is challenging at best. The spouse/caregiver is the closest to the Veteran and in the greatest position of helping to “manage” the Veteran's PTSD

and TBI symptoms. Educating the spouse who provides caregiver support to the Veteran lessons the chance they and their families will become one of the devastating statistics associated with combat Veterans.

contact

email denise@vetspouse.org
PHONE: 440-477-4704
MAIL: Hearts of Patriots
101 Denison Ave., Elyria, OH 44035

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Veteran Spouse Appreciation Spa DayRelax and connect with other Caregivers in the community​

Allergies

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Veteran Spouse Appreciation Spa Day

Relax and connect with other Caregivers in the community