Regional Workshop Registration

Event Name for RSVP Fee URL
Night of Hotel Room
Cancel Hotel Room Deadline
Cancelation Deadline (No Hotel)
No-Show Fee
Ask if they need Spanish-to-English translation services?
Event&Email
NOTE: Submission of this form constitutes your agreement to receive 40 Days for Life communications including e-mails.
Name *
First Name
First Name
Last Name
Last Name
In which country do you reside?
Address
Street Address
City
City
US State
State
Canadian Province/Territory
Province/Territory
Zip/Postal Code
Zip/Postal Code
State/Province/Territory
Country

Street Address

Street Address Line 2

CityState

Postal CodeCountry
Email
example@example.com
Phone Number
Your Vigil Location
# of Workshop Attendees
Additional team member 1
Name
Additional team member 2
Name
Additional team member 3
Name
Additional team member 4
Name
Additional team member 5
Name
Additional team member 6
Name
Additional team member 7
Name
Additional team member 8
Name
Additional team member 9
Name
If available, would you like to request English-to-Spanish translation services? For how many people?
Do you need overnight accommodations {nightOf} (free while supplies last)? *
Do you need overnight accommodations?
I need overnight accommodations for (select all that apply — free while supplies last):
- Who will be staying in your room?
- Name 1
- Name 2
- Name 3
- Name 4
- Do you wish to request a scholarship to cover your travel to the workshop?
- All guest names (including yourself) and t-shirt sizes
- How many rooms would you like to request?
- List any topics you would like the workshop to cover or provide training on:
- Any comments, special requests, or dietary restrictions?
- You have indicated that you are an EU or EEA resident and are using this form from an EU or EEA location. As of May 25, 2018 the EU has put into effect the General Data Protection Regulation (“GDPR”) which requires that you are clearly informed who is collecting, storing and accessing your personal data (“Controller”); what personal data is being collected; how it is being used; how to access it (“Right of Access”); how to have it removed/deleted/erased (“Right to be Forgotten”; how to get a copy (“Portability); restrict processing; and to object.
  
  For complete information on the EU GDPR, click: https://www.eugdpr.org
  
  WHO IS COLLECTING & USING YOUR PERSONAL DATA?
  All personal data provided by you is controlled, collected, stored, accessed and processed/used by 40 Days for Life, a charitable organization located in Texas, U.S.A.
  
  40 Days for Life only shares your personal data with our trusted partners in furtherance of our Mission to end abortion; and only with your consent.
  
  WEBSITE: https://40daysforlife.com
  ADDRESS: 4112 East 29th Street, Bryan, TX, 77802, U.S.A
  PHONE: +1-888-LIFE-316
  
  Click HERE for our PRIVACY STATEMENT.
  
  WHAT IS PERSONAL DATA?
  Personal data is information that identifies you. 40 Days for Life takes your privacy & security seriously and therefore considers almost all data about you to be personal. Below is a list of the personal data that you will be asked to provide for this application.
  
  WHERE DOES MY INFORMATION GO?
  All information provided by you will be transferred to, stored and accessed in the United States of America solely for the purpose of furthering our Mission to end abortion.
  
  YOUR AGE:
  40 Days for Life does not accept or collect information from minors/juveniles. Please check the box below to indicate whether you are at least eighteen (18) years of age, or the age of majority (if higher) in your location:
- Are you at least 18 years old, or the age of majority in my location.
- INFORMATION COLLECTED BY THIS FORM:
  
  Please click the box to the left of each item of information collected if you agree for the information to be collected: *
- CROSS-BORDER TRANSFER:
- PROCESSING & USE OF DATA :
  
  Please click the box to the left of each item of information collected if you agree for the information to be collected: *
- Contacting you via:
- COOKIES:
  40 Days for Life uses cookies to collect and analyze certain data. For complete information please click: http://www.allaboutcookies.org/
- Do you agree to the use of cookies?
- ACCESS:
  If you would like to access the personal data that 40 Days for Life maintains about you, click HERE.
  DELETION/ERASURE:
  If you would like to change or delete some or all of the personal data that 40 Days for Life maintains about you, click HERE.
  RETENTION TIME:
  40 Days for Life retains personal data as long as there is an active campaign that is relevant to you; or until you request deletion; or for two years unless you re-consent – a reconsent form will be sent to you when the two year mark is approaching.
  PORTABILITY:
  If you would like a copy of the personal data that 40 Days for Life maintains about you, click HERE. In some cases, there may be a small fee for this service.
- MEDIA RELEASE
  
  In furtherance of the 40 Days for Life Mission, we will be recording certain portions of the Workshop. Through your attendance, you grant permission for 40 Days for Life and its agents to record (photograph, film, videotape, etc.) you and all participants registered under your name, including any minors in your charge, during the Workshop.
  
  40 Days for Life may publish and/or use such recordings, for any lawful purpose in furtherance of its Mission, as it sees fit, including on its website, social media and on-line, without further notice, permission and/or compensation to you.
  
  You release and hold harmless 40 Days for Life from any and all liability that may arise, directly or indirectly, now or in the future, in connection with such recordings and/or use, for you and for all minors in your charge.
  
  We will not be able to accept opt-outs, so if you attend you agree to have your image, voice and likeness used for 40 days for Life Mission purposes!
- DISCLAIMER
  
  In the event that you need to cancel, you must do so by {cancelHotel}. If you fail to cancel on time and do not show up, your card will be charged a one-time ${noshowFee} fee to help cover costs.
- Should be Empty: