Cabin Fever 2024 Speaker Form

Please check all that apply:
Max 150 words 
Please note that biography wording or length may be adjusted for promotional requirements. 
 
 Please upload a high-resolution photo to be used in our program
 
One file only.
10 MB limit.
Allowed types: gif, jpg, png.
Please select all that apply:
Please list 3 session objectives for your presentation. 
CME Guide to Writing Learning Objectives can be found here. 
*Please note: Session titles and objectives may need to be altered for accreditation purposes.
For session speakers: Do you have a preference on which day of the conference you are scheduled to present?
Presentation Requirements
A projector/presentation system will be provided for all sessions. Laptops, adaptors and other materials may be available upon request. Requests must be submitted no later than January 3, 2024. 

Please select the tech requirements that apply to your presentation.
Waiver

I consent to participate in the program or project identified above and agree that the handout materials that I provide for the program: (1) may be printed to be distributed to course registrants, (2) that my presentation and my person may be recorded in audio, video or still image format, and (3) that both 1 and 2 may be posted on a page of the DLRI office website (cumming.ucalgary.ca/ruralmedicine) or other online platform following the date of the program. I will ensure that I will use, and am compliant with, the copyright-protected materials in accordance with the University of Calgary copyright policy, Acceptable Use of Material Protected by Copyright. Furthermore, I understand that the Copyright Office (copyright@ucalgary.ca) is available to offer guidance should I need assistance with this. I understand that the information collected will be used only for the purposes listed above. If I have any questions about the collection or use of this information, I will contact the DLRI office. I certify that I have read and fully understand this Waiver and that all questions pertaining to this Agreement have been answered to my satisfaction. 

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.