Registration Form
Registration form for the 5th Continental CBR/CBID Congress of the Americas
October 25-27, 2022
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Correo *
First name *
Last name *
E-mail address *
Contact number
Sex *
Country *
Native Language
Age *
Will you be attending the 5th Continental CBR/CBID Congress of the Americas 2022 in person or virtually?
 *
Are you a representative of an Organisation(s), Institution, NGO etc?
What is your function as it relates to CBR/CBID strategy?
Will you be attending as a (select all that apply)
 *
Obligatorio
Do you identify as a person with a disability?
 *
Do you require any type of accomodation/assistance?
What type of disability do you have? (question to ensure accommodations are provided)
 *
If attending in person and have a disability, will you be accompanied by a care giver or parent?
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If attending in person, do you have any dietary restrictions or food allergies?
 *
If you are staying at a hotel, please select from the options below.
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How did you hear about this event?
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What do you hope to gain from the Congress?
Is there any aditional information you would like to provide?
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