Register – Inclusive Health Summit

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The Summit
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Register

Come join industry leaders across the country to ignite change and ensure health justice for all

PLEASE REGISTER BY JUNE 7, 2018

Registration can be modified or transferred to another attendee by emailing inclusivehealth@specialolympics.org 
The Inclusive Health Summit is an invitation-only event.  To request an invitation, please email us.

Igniting Change: Inclusive Health Summit Registration

Name *

First

Last

Your Email *

Phone *

Job Title *

Organization *

Address

Address Line 1

City

State

Zip Code

Other Information

The aim of this Summit is to create an experience that encourages collaboration among attendees in becoming change leaders in inclusion as we work to ensure that all individuals with and without intellectual disabilities have equitable access to health.

ADA Needs: Do you require assistance to participate in the meeting? *

Yes
No

Dietary Restrictions *

None
Vegetarian
Other

Other Dietary Restrictions (if any)

How did you hear about the Summit? *

Email Invitation
Another Attendee/Word of Mouth
American Academy of Developmental Medicine and Dentistry (AADMD)
Social Media Channels
Other

Have you previously participated in a Special Olympics event on Inclusive Health?

Yes
No

Please briefly describe your interest in attending this event, and how it relates to your work

Which of the following best describes the type of organization you work at? *

Academic Organization
Professional Association
Clinic/Medical Practice
Community-Based Organization
Health system
Government
Non-Profit Organization
Corporation/Private Entity
Foundation/Philanthropic Organization
Research Center
Other

Which of the following event-related activities are you interested in attending?

American Academy of Developmental Medicine and Dentistry 2018 Conference, June 29-July 1, Seattle Marriott Waterfront
Special Olympics USA Games Opening Ceremony, July 1, Husky Stadium
Special Olympics USA Games, July 1-6, Greater Seattle area

Would you like to receive our Inclusive Health bi-monthly newsletter? *

Yes
No

Please let us know if you have any additional requirements

Thank you - We look forward to seeing you in Seattle!

Phone

Summit Location

Seattle Marriott Waterfront
2100 Alaskan Way
Seattle, Washington 98121
206-443-5000

Contact Special Olympics

inclusivehealth@specialolympics.org

Subscribe to Our Newsletter

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The Igniting Change: Inclusive Health Summit is hosted by Special Olympics International and supported by the American Academy of Developmental Medicine and Dentistry