Housing, Medical, Dietary Form

2019 MHBNE Housing, Medical and Dietary Information

All attendees, please provide contact information below.

* Indicates required field

Name *

First

Last

Email *

Contact phone number *

All attendees to MHBNE 2019 are REQUIRED to fill out this form no later than February 17, 2019.

The default housing arrangements are:

arriving on Friday, departing on Sunday (2 nights)
shared room with 2 double beds
random roommate (designate male or female)
no special meal or medical concerns

Meals Included with your registration:

Friday MHBNE dinner
Saturday Hotel breakfast buffet
Saturday MHBNE lunch
Saturday MHBNE dinner
Sunday Hotel breakfast buffet

Male or Female *

I am male and want to share a room with another male I am female and want to share a room with another female I am over 18 and do not care what gender my roommate is. I will designate a specific person to room with below. No Rally Attendee Roommate

If you have no changes to the default arrangements and have no special medical or dietary requirements, just fill in your name and email info, select an option in the Male or Female question above, check the "I am satisfied with the default arrangements" box below, and click Submit at the bottom of the page. If you do have special requests, please continue below.

Satisfied with Default Housing Arrangements *

I am satisfied with the default housing arrangements sharing a room with another assigned person as specified above. I will check this box and click Submit at the bottom of this form now.

Special Requests

I would like a single room for both Friday and Saturday nights, at an additional cost of $130. If yes, please specify in the dropdown list how many beds in the room. *

I would like to share my room with the following individual.
Note: If your prospective roommate is a registered rally attendee, they must also fill out this form and request you or no action will be taken. Please confirm with them directly, that they also designated you. *

Roommate Rally Status *

Roommate is a Rally Attendee Roommate is a Guest

I would like to arrive a day early and/or stay a day later. We will attempt, but cannot guarantee, to find you a roommate. If not, you will have to pay the single room price of $130 per night. If you have not identified a roommate, we will attempt, but cannot guarantee to find you a roommate. If not, then you will have to pay the single room rate. The extra night includes the Hotel breakfast buffet the following morning. *

Please confirm any special medical or dietary needs you may have. *

Thank you for giving us this important information. Please click Submit now to save your selections and inputs.

Please remember - you must click Submit now or your inputs and selections on this page will not be saved!

Thank you!

PS - if you have any housing or meal questions, please do not hesitate to contact Jeff, our Events planner at housing@mhbne.org

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