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BORN A PROBLEM: Panel Discussion
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What is your full name? 
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Pronouns:
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What is your age?
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What is your residential zip code?
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What is your ethnicity? Select all that apply.
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Which of the following do you identify with? Select all that apply.
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 Do you identify as: 
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Is there anything else about how you identify that you would like to share with us?
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Please share any accessibility needs.
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How did you hear about this event?
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Media Release
By registering and participating in this event, you acknowledge and grant consent for photographs and videos to be taken of you during the course of the event. These images may be used for promotional purposes, including but not limited to social media, websites, newsletters, and other marketing materials associated with the event or its organizers.

If you are under the age of 18, your parent or legal guardian needs to grant consent for the capture and use of photographs and videos.

Your participation in the event constitutes acceptance of these terms. If you do not wish to have your photograph or video taken or used for promotional purposes, please inform a member of the event staff at the registration desk.  
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If you have any concerns or questions about the use of your image, please contact us at homemadelit@gmail.com.
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