Delegate Information Form

Name*

First Last

Organisation*

Job Title*

Emergency Contact

Emergency Contact Name*

First Last

Emergency Contact Phone*

Consent

Do you consent to your name, title and organisation being shared with other attendees and sponsors? A delegate list will be emailed to all registered delegates a few days prior to the conference to facilitate networking.*

Yes
No

Do you consent to RTC using images taken of you at this event?*

Yes
No

Use includes the display, distributions, publications, transmissions or otherwise use of photographs, images and/or videos taken for use in materials that include, but may not be limited to, printed materials such as Brochures, Newsletters, Videos and digital images used on RTC’s Website and Social Media Pages.

Emergency Contact

Consent

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