CureSearch Pediatric Early Development Symposium Registration Please fill out the following form to complete your registration.Early-Bird Registration, before June 30, 2020Select one belowIndustry (pharma, biotech, CRO, etc.)Academia/GovernmentNon-ProfitFirst Name* First Last Name* Last Medical or Academic TitleRole*Organization*Phone Number*Email Address* Assistant's email (if applicable) Please select any dietary restrictions*NoneGluten-freeVeganVegetarianKosherPlease provide a short bio (200 word max)*Please attach a headshot (LinkedIn or professional photo). If a photo is not provided, no photo will appear in the 2020 PEDS Bio Book. We do not recommend using files smaller than 1200x1800 pixels.I will attend the following (select all that apply)* Select All Day One: Thursday, October 1, 8:00 a.m. – 9:00 p.m.Including Reception & Dinner Day Two: Friday, October 2, 8:00 a.m. - 4:00 p.m. Individual Photo & Video Release*I consentI do not consentPlease read and review the Photo & Video Release form.Registration Fee $0.00 Before submitting this form, please note that if you have any money due in the field above, you will be redirected to a final form where you will need to enter this amount, along with your credit card information, to be charged. Please still submit this form either way, so we will have your answers to the questions above.NameThis field is for validation purposes and should be left unchanged.