• Conference Registration Form

    Sign-ups for activities and purchasing of t-shirts will follow closer to the conference dates.
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  • Additional Attendee(s)


  • PUBLICITY WAIVER & RELEASE

    I hereby irrevocably permit, authorize, grant, and license The Wiedemann-Steiner Syndrome Foundation, a California Nonprofit Corporation, (“Foundation”), and its affiliates, successors, and assigns, and the employees, officers, directors, volunteers and agents of each and all of them (”Authorized Persons”), the rights to display, exhibit, transmit, broadcast, reproduce, record,
    photograph, digitize, modify, alter, edit, adapt, create derivative works, exploit, sell, rent, license, otherwise use, and permit others to use my and/or my child/children’s name, image, likeness, appearance, voice, actions, biographical information, and all materials created by or on behalf of the Foundation that incorporate any of the foregoing (”Materials”) in perpetuity in any medium
    or format now existing or hereafter created, including but not limited to, in and on magazines, brochures, newsletters and other print publications, electronic, magnetic, and optical media, video, television broadcast, cablecast, and satellite, home video and video on demand, livestream, radio broadcasts, display, and other advertising and promotional materials, press releases, the internet and other digital transmission or delivery methods, mobile applications, on any platform for any purpose, including but not limited to fundraising, advertising, public relations, education, awareness, publicity, packaging, and promotion of the Foundation and its affiliates and their products and services, without further consent from or royalty, payment, or other compensation to me and/or my child/children.


    The Foundation shall be the exclusive owner of all rights, including copyright, in the Materials. I hereby irrevocably transfer, assign, and otherwise convey to the Foundation my entire right, title, and interest, if any, in and to the Materials and all copyrights and other intellectual property rights in the Materials arising in any jurisdiction throughout the world, including all registration, renewal, and reversion rights, and the right to sue to enforce such copyrights against infringers. I acknowledge and agree that I have no right to review or approve Materials before they are used by the Foundation, and that the Foundation has no liability to me for any editing or alteration of the
    Materials or for any distortion or other effects resulting from the Foundation’s editing, alteration, or use of the Materials, or the Foundation’s presentation of me and/or my child/children. Any credit or other acknowledgment of me and/or my child/children, if any, shall be determined by the Foundation in the Foundation’s sole discretion. The Foundation has no obligation to create or use
    the Materials or to exercise any rights given by this release.

    To the fullest extent permitted by applicable law, I hereby irrevocably waive all legal and equitable rights relating to all liabilities, claims, demands, actions, suits, damages, and expenses, including but not limited to claims for copyright or trademark infringement, infringement of moral rights, libel, defamation, invasion of any rights of privacy (including intrusion, false light, public
    disclosure of private facts, and misappropriation of name or likeness), violation of rights of publicity, physical or emotional injury or distress, or any similar claim or cause of action in tort, contract, or any other legal theory, now known or hereafter known in any jurisdiction throughout the world (collectively, “Claims”) arising directly or indirectly from the Authorized Persons’
    exercise of their rights under this Publicity Waiver and Release or the production, exhibition, exploitation, advertising, promotion, or other use of the Materials, and whether resulting in whole or in part by the negligence of the Foundation or any other person, covenant not to make or bring any such Claim against any Authorized Persons, and forever release and discharge the Authorized Persons from liability under such Claims.

    I have carefully read this Publicity Waiver and Release and fully understand its contents. I am aware that this is a release of any potential liability and a contract between myself and the Foundation and any other Authorized Persons, and sign this Publicity Waiver and Release on my own free will.

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  • Medical Release, Liabilty Waiver and COVID-19 Waiver: Assumption of the Risk, Medical Release/Consent to Treatment, and Release/Indemnification Agreement

    I (We) hereby give permission for any supervisor, volunteer, lifeguard, administrator, agent, independent contractor, or employee associated with the Wiedemann-Steiner Syndrome Foundation (“Foundation”) to seek and give appropriate medical attention to any attendee(s) listed above (“Attendee(s)”) in the event of accident, injury, or illness during the Wiedemann-Steiner Syndrome Foundation International Family Conference (“Event”). I (We) will be responsible for any and all costs associated with any necessary medical attention and/or treatment for Attendee(s).

    I (We) hereby authorize the Foundation, to obtain and/or perform as appropriate, medical assistance as needed, including treatment and hospital care to be rendered to the Attendee(s), and I (we) agree to pay any and all costs for the foregoing. I (We) have no knowledge of any physical or mental impairment that would affect each Attendee’s ability to safely participate in the Event.

    On behalf of myself (ourselves) and the Attendee(s), I (we) understand and acknowledge that there are inherent risks in participating in the Event, and that the Attendee(s) may be exposed to circumstances and dangers arising from situations beyond the immediate control of the Foundation, and other undefined harm or damage which may not be readily foreseeable; and other presently unknown risks and dangers. I (We) understand that participation involves risks and dangers which include, without limitation, the potential for serious bodily injury, illness (including contracting COVID-19), permanent disability, paralysis and death. I (we) understand that these risks may be caused in whole or in part by the actions or inactions of Attendee(s), or the actions or inactions of others participating, or the acts, inaction or negligence of the Foundation and other released parties. On behalf of myself (ourselves) and the Attendee(s), I (we) voluntarily and knowingly recognize, accept and assume these risks.

    I hereby waive, release and forever discharge any and all of the Foundation and any associated supervisor, agent, employee, volunteer, independent contractor, lifeguard or other administrator from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in activities related to the Event, whether or not damages or loss are due to negligence of the Foundation.   

    By the Attendee(s) being registered and/or allowing Attendee(s) to participate in the Event, I (we) hereby agree to indemnify, release, and hold harmless any and all of the Foundation, from liability for any injury that might occur to the Attendee(s), myself (ourselves) or anyone accompanying the Attendee(s), while present at any location or facility being used for the Event, including travel to and from the Event, including but not limited to property damage or personal injury, including COVID-19, serious injuries resulting in paralysis or death.

    COVID-19 Liability Waiver and Assumption of Risk 

    In consideration of being allowed to participate and/or attend the Wiedemann-Steiner Syndrome Foundation International Family Conference (“Event”), I (we) agree(s) as follows:


    1. I (We) am (are) aware that the novel coronavirus (“COVID-19”) is an extremely contagious virus and that it is currently believed that COVID-19 spreads through person-to-person contact.


    2. I (We) am (are) familiar with the Center for Disease Control and Prevention (”CDC”) guidelines regarding COVID-19, which are located at https://www.coronavirus.gov. I (We) acknowledge and understand that the circumstances regarding COVID-19 are changing from day-to-day, and that the CDC guidelines are regularly modified and updated. I (We) accept full responsibility for familiarizing myself (ourselves) with the most recent updates, and making informed choices to take precautionary measures to protect myself (ourselves) and others.


    3. In addition to the CDC guidelines, I (we) agree to abide by any and all policies or postings published to the general public at the Event. 


    4. By signing this COVID-19 Liability Waiver and Assumption of Risk, I (we) acknowledge that I (we) am (are) aware of the contagious nature of COVID-19 and voluntarily assume the risk that my (our) child(ren), myself (ourselves) and other Event Attendee(s) in my party may be exposed to or infected by COVID-19 at the Event, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I (We) understand that the risk of becoming exposed to or infected by COVID-19 at the Event may result from the actions, omissions, or negligence of myself (ourselves) and others.


    5. I (We) agree that, in the event that I (we) suspect I (we), my (our) child(ren), and other Event Attendee(s) in my party became exposed to or infected by COVID-19 at the Event and elect to seek testing and/or treatment as a result therefrom, I (we) will be responsible for payment of any and all medical services and testing services. 


    6. I (We) voluntarily, choose to assume all of the foregoing risks and accept sole responsibility for any injury, illness, permanent disability, or death related to COVID-19 arising from or in connection with the presence of my (our) child(ren), myself (ourselves) and other Event Attendee(s) in my party at the Event. I (We) hereby release, hold harmless, and indemnify the Wiedemann-Steiner Syndrome Foundation, their employees, agents, directors, officers, volunteers, assistants, independent contractors, administrators and representatives and other Attendee(s) from and against all liabilities (statutory or otherwise) for claims, suits, demands, judgments, costs, interest and expense (including but not limited to attorney’s fees and disbursements) for injury, illness, permanent disability, or death related to COVID-19 arising from or in connection with the presence of myself (ourselves), my (our) child(ren), and other Event Attendee(s) in my party at the Event, EVEN IF ARISING FROM THE NEGLIGENCE, ACTS OR OMISSIONS OF THE RELEASED PARTIES.

     

     

     

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  • FOR MINOR CHILD/CHILDREN OR PERSON(S) WITH LEGAL GUARDIAN/REPRESENTATIVE: I (we) am (are) the parent or legal guardian(s)/legal representative(s) of any and all minor(s) or person(s) named as Attendee(s). I have the legal right to consent to and, by signing below, I hereby do consent in all respects to the terms and conditions of these Medical Release and Liability Waiver and COVID-19 Liability Waiver and Assumption of Risk, and agree that the minor(s)/incapacitated person(s), myself (ourselves) and any other Attendee(s) registered above shall be bound by all of its terms and conditions.

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  • Cancellation Policy

    To receive a full refund for the registration fee(s) of the Wiedemann-Steiner Syndrome Foundation International Conference (“Event”), I (we) understand that I (we) must provide cancellation notice to the Wiedemann-Steiner Syndrome Foundation by October 17, 2022. Notice of valid cancellation is to be sent to info@wssfoundation.org. I (We) understand that cancellation for the registration fee(s) of the Event made after October 17, 2022 will not receive a refund of any registration fee(s) of the Event.


    I (we) understand that this Cancellation Policy applies to the Event registration fee(s) only. This Cancellation Policy does not apply to any accommodations that I (we) may reserve at Turf Valley Resort or elsewhere. (Please contact Turf Valley Resort or wherever reserve accommodations are reserved for its (their) own cancellation policy.)

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  • Note: Payments are processed through PayPal.  You may pay using an existing PayPal account, or any major credit card / debit card.
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