New Orleans Academy of Ophthalmology
2023 Annual Symposium
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2023 Symposium Resident/Fellow Registration
2023 Annual Symposium Resident/Fellow Registration
Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Congo, Democratic Republic of the
French Southern Territories
Heard Island and McDonald Islands
Isle of Man
Korea, Democratic People's Republic of
Korea, Republic of
Lao People's Democratic Republic
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
South Georgia and the South Sandwich Islands
Svalbard and Jan Mayen
Syria Arab Republic
Tanzania, the United Republic of
Trinidad and Tobago
Turks and Caicos Islands
US Minor Outlying Islands
United Arab Emirates
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Will you attend in-person or virtually?
Full name of spouse (if attending) or other guest
What specific topics/talks are you interested in seeing presented at this year's symposium?
WORKSHOP REGISTRATION COMING SOON!
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
The National Association of Disability Representatives (“Organization”) have put in place preventative measures to reduce the spread of COVID-19; however, the Organization cannot guarantee that you will not become infected with COVID-19. Further, attending an in-person educational conference could increase your risk and of contracting COVID-19.
By submitting event registration, I, the undersigned, acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending the NOAO 2022 Annual Symposium (“Event”) and that such exposure or infection may result in illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, speakers, and attendees.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for illness of any kind that I may experience or incur after attending this Event. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless Organization, its affiliates, and their respective officers, directors, employees, and agents (“Released Parties”), of and from the any claims, including all liabilities, claims, actions, costs or expenses of any kind arising out of or relating thereto (“Claims”). I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Released Parties, whether a COVID-19 infection occurs before, during, or after participation the Event.
In the event that despite the existence of this document there is a basis to file a claim against any of the parties released hereunder, I agree that I will only file an arbitration matter to be conducted by the American Arbitration Association. I agree that such a claim must be brought within 12 months of first experiencing any COVID related symptoms, and beyond that date any claim is forever waived. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
By submitting my event registration, I agree that if I am exposed or infected by COVID-19 during my participation at the conference, then I may be found by a court of law or arbitrator to have waived my right to maintain a lawsuit or claim against the parties being released.
I also agree to abide by any COVID safety protocols instituted by Event managers and host hotel.
NOTE - Registration as Resident/Fellow must be accompanied by supporting letter mailed to firstname.lastname@example.org before registration can be completed
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