REGISTRATION FORM

Full Name

E-mail address

Phone number

Organization

Job title

Category in which you are registering Category in which you are registering Exhibitor Speaker Moderator Organization Partner Participant

Date you want to participate in the event Date you want to participate in the event June 20th June 21st June 20th and 21st

Means of transportation you are taking to the venue Means of transportation you are taking to the venue Own car Public transportation Shared transportation

Accessibility and special needs, if needed specify below:

Other relevant information, such as dietary requirements or allergies, specify below:

By registering to the event you agree with the colletion and the use of your image and sound for communication and for promotion of the event. The validity of the informed consent is unlimited. The images captured (photo and video) may be used by the event organizers, partners, and other direct interlocutors. By registering to the event you agree with the colletion and the use of your image and sound for communication and for promotion of the event. The validity of the informed consent is unlimited. The images captured (photo and video) may be used by the event organizers, partners, and other direct interlocutors. I authorize the use of content and data collected by Portugal Inovação Social and the Social Innovation Village partners.