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Registration Form
Registration form for the 5th Continental CBR/CBID Congress of the Americas
October 25-27, 2022
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Email *
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)
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?
Clear selection
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.
Clear selection
How did you hear about this event?
Clear selection
What do you hope to gain from the Congress?
Is there any aditional information you would like to provide?
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