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Attendee Information
First Name
*
Last Name
*
Title
*
Organization or Affiliation
*
Email
*
Phone
*
Address
*
Address
Address
Address
City
City
State/Province
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Zip/Postal
At the Summit
Which days do you plan to attend?
*
Tuesday, Aug. 20
Wednesday, Aug. 21
If you're not sure, please mark both.
Pronouns for name badge
*
She/her/hers
He/him/his
They/them/theirs
She/her/they
He/him/they
She/her/ella
He/him/él
Do not include pronouns on my badge
Other (describe)
Your pronouns
*
Do you need any accommodations to participate in this event?
*
No
Yes
Describe the accommodations you need
*
Dietary accommodation requests (check all that apply)
Gluten-free
Dairy-free
Vegetarian
Vegan
Other dietary requests or food allergies
What registration fee works best for you?
*
Pay-what-you-can (name your own price)
Free (no charge)
Pay-what-you-can Registration Fee
*
85
Suggested fee is $85 for one day, $170 for both days. Use the slider to select a fee that works for your budget. If you have no budget available to support your attendance, choose $0. Any payment will be used to offset catering costs, venue rental, and keynote presenter fees.
Credit Card
*
In 1-2 sentences, tell us what attending this event will mean for you and the work you do with youth
*
We will share your response to this question with our funders who make it possible for us to offer reduced registration fees.
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