SPEAKER REGISTRATION

Speaker Full Name:*
First Last
Email Address:*
Contact Phone Number:
Mailing Address:
Preferred Professional Title:
Title of presentation:
Please provide a short 300 word abstract regarding your presentation*
Authorisation
Please can you confirm that no part of your presentation is copied from any other work without permission, and that you have obtained all the permissions required (for print and electronic use) for any material you have used from other copyrighted publications in the presentation. As a presenter it is requested that you exercise all reasonable care to ensure that the Presentation is accurate and does not contain anything which is libellous, or obscene, or infringes on any ones’s copyright, right of privacy, or other rights.
- I confirm as a presenter that I have obtained copyright permissions where required (please tick to confirm). (All confidential/copyrighted removed or identified prior to release)
If you do not have copyright permission, please indicate the slide pages below
Content Release
- I agree for my presentation to be published on the 2023 INSIGHT conference website under restricted access for up to 12 months.
- I agree for my presentation to be re-purposed into a podcast following the conference
- I agree to participate in a live Q&A interview or panel
- I agree to be featured in PR and Media promotion of the conference
- I declare that I do not have any conflicts of interest (commercial, non-commercial or research)
Statement of conflict:
Biography:
High resolution head shot:
Max. file size: 256 MB.
Virtual signature:
Date:
MM slash DD slash YYYY

SPEAKER REGISTRATION

Authorisation