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Conference Registration
This year's conference will focus on Spina Bifida across the Life Span. It will be a one day event and take place on October 31, 2026 from 8am - 5pm. Please complete the fields below to secure your place for this year's conference!
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Number of Adults attending (including yourself)
*
Names of Additional Adults Attending
Number of Children attending
Names of Children Attending
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Individual with Spina Bifida
First Name
Last Name
Emergency Contact (an adult not in attendance)
*
First Name
Last Name
Emergency Contact Phone Number
*
Format: (000) 000-0000.
Will you require an interpreter? If so, which language?
Please Select
Arabic
ASL
Portuguese
Spanish
Other
N/A
Language needed, if not listed above
Babysitting/Child Care
For children under 12 we will have an on-site kid's club with licensed child care workers
Name(s) of Child/Children
Age(s)
Dietary Restrictions
Allergies
Gluten Free
Vegan
Vegetarian
Nut Allergy
N/A
Other additional dietary or accessibility concerns/needs?
Transportation Voucher Request
We can provide limited financial assistance on a first come, first served basis for transportation purposes for those that need it. Please check here if you require assistance
I would like to request financial assistance getting to/from the conference
N/A
Liability Waiver Acknowledgement
Please review the following text and acknowledge that you have read and agree.(We), as parent(s) or guardian(s) of the minor, do hereby, for my/our self, heirs, executors and administrators, remise, release and forever discharge the Spina Bifida Association of Greater New England, all of the officers, employees, and agents of each of the foregoing acting officially otherwise, from any and all claims, demands, actions or causes of action on account of my/our self(ves) and my minor child. I hereby certify that the minor is my/our child.In case of accident, permission is granted for emergency treatment to be administered. It is further understood that I/we will assume full responsibility for any such action, including payment of costs. I/we hereby advise that any allergies or special considerations for myself and the above named minor has been disclosed during this registration process.
By checking this box you acknowledge and agree to the liability waiver set forth above
*
I agree
Photo Release
I agree that SBAGNE may use photos of me and/or my minor children from the Conference for promotional material both digital (social media, emails, et al) and print (annual campaign, newsletters, et al).
By checking this box you acknowledge and agree to the photo release as set forth above
*
I agree
Registration Fee
*
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Adult - Conference Registration (including Breakfast & Lunch)
$50.00
$
50.00
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Child (up to 12 years old) - Conference Registration (including Breakfast & Lunch)
$25.00
$
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Student Pricing - Conference Registration (including Breakfast & Lunch)
$40.00
$
40.00
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Payment Methods
Credit Card Number
Security Code
Expiration Month
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Expiration Month
Expiration Year
2026
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Expiration Year
Registration fee scholarship
Please send all requests to execdirector@sbagreaterne.org to request a scholarship for a portion of the registration fee.
Hotel Reservations
We have secured a room block for Friday October 30th at the host site of the conference - Crowne Plaza Warwick - at a reduced rate, room block rates expires September 30. You will receive a link and discount code in your confirmation email once checkout is complete. You can also return to the site - https://sites.google.com/sbagreaterne.org/educational-conference and follow the link there.
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