ISSWSH Annual Meeting 2022 - Online registration

ISSWSH Member
	Physician - Member
	Non-Physician/Health Professional - Member
	Early Career Professionals (physician)* - Member
	Early Career Professionals* - Member
	Fellow ** - Member
	Resident** - Member
	Student** - Member
	Industry Representative*** - Member
	Patient Advocate - Member
	Physician - Non-Member
	Non-Physician/Health Professional - Non-Member
	Early Career Professionals (physician)* - Non-Member
	Early Career Professionals* - Non-Member
	Fellow** - Non-Member
	Resident** - Non-Member
	Student** - Non-Member
	Industry Representative*** - Non-Member
	Patient Advocate - Non-Member

ISSWSH remains fully committed to holding a successful in-person Annual Meeting at the Renaissance Dallas Hotel, Dallas, TX in March 2022. The priority of ISSWSH remains the health and well-being of our community. Due to the continuing prevalence of COVID-19, as a registrant and attendee of the 2022 ISSWSH Annual Meeting you are required to understand and agree to the terms on the following page:

COVID Requirements

Tick to agree

I represent that I understand the risks and ramifications associated with attending the 2022 ISSWSH Annual Meeting and agree to assume any and all risks, whether said risks are known or unknown at this time. Moreover, I forever release ISSWSH, its staff, officers, directors, volunteers, contractors, representatives, related companies, and its board from any and all liabilities, causes of action, lawsuits, claims, demands, or damages of any kind whatsoever that I, my assignees, or my heirs may have.

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and ISSWSH. I understand the above, agree to abide by its terms, and sign it on my own free will.

COVID Requirements

YOU ARE ELECTRONICALLY SUBMITTING THIS APPLICATION TO ISSWSH. PLEASE APPLY YOUR ELECTRONIC ACKNOWLEDGEMENT TO THIS FORM BY CHECKING THE ACCEPTANCE BOX BELOW. BY DOING SO, YOU HEREBY CONSENT AND AGREE THAT YOUR USE OF A KEYPAD, MOUSE, OR OTHER DEVICE TO CHECK THE ACCEPTANCE BOX CONSTITUTES YOUR SIGNATURE, ACCEPTANCE, AND AGREEMENT AS IF ACTUALLY SIGNED BY YOU IN WRITING AND HAS THE SAME FORCE AND EFFECT AS A SIGNATURE AFFIXED BY HAND.

AUTHORIZED REPRESENTATIVE’S ELECTRONIC ACCEPTANCE

ISSWSH Annual Meeting 2022, March 3-6, 2022, Dallas, TX, USA