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pac@parkinsonassociation.org
About
About
Meet the PAC Team
Contact Us
Understanding Parkinson’s
What is Parkinson’s disease?
Diagnosis & Symptoms
Treatment & Therapies
Maintaining Quality of Life
Care Partner Resources
Parkinson’s Disease Glossary of Terms
Additional Resources
Make an Impact
Donate Now
Ways To Give
Volunteer Opportunities
Potential Speakers Interest Form
Community Involvement
Our Partners
Get Help and Support
Programs and Services
Support Groups
Exercise and Movement Classes for Parkinson’s Disease
Parkinson’s Disease Care Partner Resources
Events
PAC Exercise and Movement Therapy Calendar
PAC Support Groups
Wellness Wednesday
Education Events
Signature Symposium
Care Partner Summit
MoveIt Walks
News
pac@parkinsonassociation.org
(980) 245-2786
Join Our Newsletter
Donate Now
(980) 245-2786
Donate Now
About
About
Meet the PAC Team
Contact Us
Understanding Parkinson’s
What is Parkinson’s disease?
Diagnosis & Symptoms
Treatment & Therapies
Maintaining Quality of Life
Care Partner Resources
Parkinson’s Disease Glossary of Terms
Additional Resources
Make an Impact
Donate Now
Ways To Give
Volunteer Opportunities
Potential Speakers Interest Form
Community Involvement
Our Partners
Get Help and Support
Programs and Services
Support Groups
Exercise and Movement Classes for Parkinson’s Disease
Parkinson’s Disease Care Partner Resources
Events
PAC Exercise and Movement Therapy Calendar
PAC Support Groups
Wellness Wednesday
Education Events
Signature Symposium
Care Partner Summit
MoveIt Walks
News
About
About
Meet the PAC Team
Contact Us
Understanding Parkinson’s
What is Parkinson’s disease?
Diagnosis & Symptoms
Treatment & Therapies
Maintaining Quality of Life
Care Partner Resources
Parkinson’s Disease Glossary of Terms
Additional Resources
Make an Impact
Donate Now
Ways To Give
Volunteer Opportunities
Potential Speakers Interest Form
Community Involvement
Our Partners
Get Help and Support
Programs and Services
Support Groups
Exercise and Movement Classes for Parkinson’s Disease
Parkinson’s Disease Care Partner Resources
Events
PAC Exercise and Movement Therapy Calendar
PAC Support Groups
Wellness Wednesday
Education Events
Signature Symposium
Care Partner Summit
MoveIt Walks
News
Registration for EmpowerED Myrtle Beach
EmpowerED Myrtle Beach
Registration for the June 20 EmpowerED Program in Myrtle Beach, SC
Register by Tuesday, June 16
First Name
(Required)
Last Name
(Required)
Address
(Required)
Mailing Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP / Postal Code
Email
(Required)
Phone
(Required)
What is your connection to the Parkinson Association of the Carolinas?
(Required)
Person with Parkinson’s Disease
Spouse/Care Partner
Adult Child of a Person with Parkinson’s
Other Family Member
Friend
Speaker
Sponsor
Other
Please select any dietary restrictions. Lunch will be provided.
(Required)
Food Allergies
Gluten Free
Vegetarian
Other
No dietary restrictions
If you selected "Food Allergies" or "Other," please specify the dietary restriction.
Do you need to register another person?
(Required)
Yes
No
Additional Attendee Name:
What is their connection to the Parkinson Association of the Carolinas?
Person with Parkinson’s Disease
Spouse/Care Partner
Adult Child of a Person with Parkinson’s
Friend
Speaker
Sponsor
Other
Please select any dietary restrictions. Lunch will be provided.
Food Allergies
Gluten Free
Vegetarian
Other
No dietary restrictions
If you selected "Food Allergies" or "Other," please specify the dietary restriction.
How did you hear about this event?
(Required)
Email Announcement or Invitation
Parkinson Association of the Carolinas website
Social Media
From my doctor
From a friend
Other
What do you hope to gain from this event?
(Required)
Please select your email communication preferences.
(Required)
Monthly Newsletter: Sent on the 1st of the month with educational resources, events, exercise classes, and news
Programs & Events: Info about exercise classes, webinars and support groups, other in-person and virtual events
Donor Communications: Financial giving opportunities
Special Communications: Important announcement
Volunteer Communications: Way to volunteer your time
Please do not email me
Select All
Photo/Media Release
(Required)
All participants and attendees grant the Parkinson Association of the Carolina permission to photograph, video record, and/or otherwise capture their likeness. Photos, videos, and other media may be used for educational, promotion, and information purposes without payment or consideration. This may include use in print or digital format, including social media, website, newsletter, and other communications. It is understand and agree to that these materials are the property of the Parkinson Association of the Carolinas. Please indicate below if you agree to the photo/video release.
Yes
No
Is there anything else we should know?
Δ