International Sickle Cell Caregiver Summit Event Registration

International Caregiver Event Registration

This form is only for international attendees. After you submit, you’ll receive an email from the Caregiver Summit tech team confirming your registration, and you should watch for a direct Zoom link from Zoom to enter the event. Thank you for using this route; due to Zoom Events limitations, this form is used to register you. We look forward to seeing you, and while you may invite other caregivers, only international attendees may register.
Attendee type
First name
Last name
Email address
example@example.com
Contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
Country of residence
Please tell us what country you are from.
Country of residence
Age range
How do you describe your gender?
If you selected “Another gender identity,” please describe.
How do you describe your race or ethnicity? Select all that apply.

Other
If Other, please specify.
If you selected “Another race or ethnicity,” please describe.
Including this year, how many Sickle Cell Caregiver Summits have you attended?
What do you most hope to gain from attending the Summit? Select up to three.

Other
If you selected “Other,” please tell us what you hope to gain from attending the Summit.
Which of the following describe your connection to the sickle cell community? Select all that apply.

Other
Organization or company name
Title or role
What is your relationship to the person you support?

Other
If Other, please describe your relationship.
Is the person you support an adult or a minor?
Will the person you support attend the Summit?
How did you hear about the Sickle Cell Caregiver Summit? Select all that apply.

Other
If Other, please tell us how you heard about the Summit.
Do you have any questions, comments, or information you would like to share with the Caregiver Summit Planning Team?
The Sickle Cell Caregiver Summit may be recorded and photographed for educational, archival, and promotional purposes. By selecting “Yes, I grant permission,” you authorize The B Strong Group, acting on behalf of the Caregiver Summit Planning Team, and its authorized event partners and vendors to record, reproduce, publish, and use your image, voice, statements, photographs, audio, or video in connection with the Summit, without compensation. Selecting “No” will not prevent you from registering or attending. Please keep your camera and microphone off if you do not want to appear in event recordings. Do you grant promotional media permission? Do you grant promotional media permission?
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International Caregiver Event Registration