Families United 4 Justice National Network Gathering, June 28th-July 1st, 2018
If you have not joined Families United 4 Justice Network, please join the Network at http://www.fu4jgroup.website/join.html. Priority is given to Network Memberships.

Registration is open to first 75 registrants. Online registration ends on June 26th, 2018.

Thank you for your interest!

Email address *
Are you a Member of FU4J Network? *
First & Last Name *
Your answer
Cell Number
Your answer
City & State & Zip Code *
Your answer
Are you a family member of someone who died during a police-related incident? *
First & Last Name of your loved one?
Your answer
Your relationship to Loved one murdered *
Are you bringing children? *
How many children? *
How many are you registering? Limit is 4. Include Yourself, Children, Spouse, others - example yourself and child equals 2 *
Registrant 1- First & Last Name is yourself as registrant 1
Your answer
Registrant 2 - First & Last Name - example is spouse or significant other or child
Your answer
Registrant 3 - First & Last Name - example is child or family member
Your answer
Registrant 4 - First & Last Name - example child or family member
Your answer
Do you have an organization? *
Organization Name
Your answer
Will you be staying at the hotel *
Which Hotel do you plan to reserved. Host Hotel is the Hilton *
Room Type? (All rooms are non-smoking)(most room are double Beds - two to a room) *
Do you have any accessibility needs? *
What are your accessibility needs?
Your answer
Do you have any dietary restrictions we should note? *
What are your dietary restrictions?
Your answer
Friday Workshop Choices choose only two *
Type in a workshop you would like to see presented
Your answer
Extracurricular Activities
On Saturday, June 30th, after the morning session, we will have the afternoon off to relax before the evening banquet. We would like for you to share with us what you would like to do during that afternoon break. You are free to do whatever you like during this time, but we are also canvassing the families to see what activities you all might be interested in participating, if we had them available. Please fill out this form so that we can plan a great conference for you :)
Saturday Events Selection
Would you be interested in receiving a therapy session from any of the following? Choose two *
How did you learn about our National Network Gathering? *
A copy of your responses will be emailed to the address you provided.
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