Bobby Jones Chiari & Syringomyelia Foundation Logo

In-Person Educational Lecture and Support Meeting Registration

Monday, November 7, 2022

5:00PM Patient to Patient Discussion Group
6:30PM Lecture

I hereby irrevocably agree and consent that you, Bobby Jones Chiari & Syringomyelia Foundation, and your assigns may use all or part of your videotaped or filmed footage of me for your documentary/ educational programs about Chiari, syringomyelia and related disorders. You have the right to use my picture, silhouette and other reproductions of my likeness and voice in connection with any motion picture, television program, fundraising video, web or print material in which this interview may be incorporated, and/or in any advertising material promoting it. You may edit my appearance as you see fit. You shall have all right, title and interest in any and all results and proceeds from said use or appearance. The rights granted you are perpetual and include the use of this educational event/interview in any medium all or part of the program may be shown, including broadcast and cable television, videocassettes, DVDs, internet, or any future technologies developed for distribution and/or exhibition. You are not obliged to make any use of this footage or exercise any of the rights granted to you by this release.

_____________________

Want to see more meetings like this one?

You are never obligated to give any money to attend any educational lectures or support meetings hosted by Bobby Jones CSF... EVER. All lectures are available to families and patients in need, at any time. Free of charge.

But if you're feeling especially generous, feel free to give today! Any little bit you can afford can help millions around the world access better information about Chiari, syringomyelia and related disorders.

Optional Donation


$
  • This is a secure 256-bit SSL encrypted payment
    Credit Card CVV number example
    Credit Card CVV number example
    /
    This field is required.
    Expired Credit Card
    Credit Card CVV number example
    Discover, Mastercard, Visa 3-Digit Card Verification Number
    Amex CVV number example
    American Express 4-Digit Card Verification Number
    255 character limit
    0 / 255
    Select eCard Image
    Processing...
    GiveSmart Fundraise
    PCI Compliance Certification 2022
    Terms and Conditions
    Privacy Policy