This document provides information about the 18th annual Hudson Valley Regional Perinatal Public Health Conference on the topic of resilience. The conference will be held on November 13, 2019 from 8:30am to 4:00pm at the DoubleTree Hotel in Tarrytown, NY. Early registration before October 11th is $75, late registration after October 11th is $100. The registration includes breakfast, lunch, and conference materials. Attendees can request education credits. A registration form is included to submit payment and dietary preference information.

1. 18th
HUDSON VALLEY REGIONAL PERINATAL PUBLIC HEALTH ANNUAL CONFERENCE
Resilience: Supporting Individuals, Families, and Communities to Improve Health Across the
Lifecourse
Date: Wednesday, November 13, 2019
Time: 8:30 a.m. – 4:00 p.m.
Exhibit Hall opens at 8:30.a.m.
Registration opens at 8:30 a.m.
Location: DoubleTree Hotel by Hilton
455 South Broadway, Tarrytown, NY 10591
Early Registration, before 10/11/19: $75
Late Registration, after 10/11/19: $100
*includes breakfast, lunch and conference materials
*Make check payable to: Children’s Health and Research Foundation, Inc.
Please fax this form to: Attn: Jitzy Marrero at 914-493-1005. (Phone # 914-493-8486) OR mail form with payment to: Jitzy Marrero, The
Regional Perinatal Center, Maria Fareri Children’s Hospital at WCMC, 100 Woods Road, Valhalla, NY 10595, by October 11, 2019.
REGISTRATION FORM – Date: _______________
Last Name
First Name
Degree/Title
Profession MD/DO RN/LPN Health Educator
Administrator Social Work Licensed Mental Health Counselor
Lactation Consultant Other :
Organization/Business/Hospital
Address
City/State/Zip Code
County of Employment
Phone
Fax
E-mail
Method of Payment Visa MasterCard/Discover
Amex Check/Money Order
Card/Check Number*/Bank
Card Expiration Date
Security Code Number
Card Owner
Home Address
Home City/State/Zip
Requesting Education Credits CME CNU CERP None
Social Work CEU - LMSW # ____________ LCSW # ______________
Licensed Mental Health Counselor CE – LMHC # ____________
Early Registration
(before October 11, 2019)
$75.00
Late Registration
(after October 11, 2019)
$100.00
TOTAL $
Lunch Kosher Vegetarian Other: