2018 Sharing Knowledge conference registrations

Attendee Information

1. Please complete the registration below—answer N/A for any you wish to leave blank. *This question is required.

First Name
Preferred Name for Badge (if different)
Last Name
Title
Organization
Country
Address
City
State/Province
ZIP/Postal Code
Email Address
Work Number
Mobile Number
Emergency Contact Name
Emergency Contact Number

3. Are you a government employee? *This question is required.

4. Please note any accessibility requests in the space provided (e.g. wheelchair, visual, audio, etc.).

5. Please list any dietary restrictions in the space provided.

Release Agreement

I understand that portions of this meeting will be webcast and agree that registration for, and participation in, any and all activities related to the meeting named above constitutes permission for Robert Wood Johnson Foundation and its agents, representatives, co-funders, contractors, employees, and grantees, (collectively, “RWJF") to photograph and record me. I further give RWJF permission to use any such photographs, recordings, or materials that might be created from them, in whole or in part, and with or without my name, in publications, presentations, websites, social media services, digital streaming or any other types of communications to advance its charitable goals, which include, but are not limited to, education, training, research, public relations, marketing, and use by or for the news media. I agree that I will not have the right to inspect or approve the use of any such photographs, recordings, or materials that may be created from them, now or in the future, and I release any and all legal claims against RWJF or third parties related to the photographs, recordings, or materials that may be created from them.

*This question is required.

Yes, I agree