Event Registration

SAFE Credit Union Convention Center
1400 J Street • Ballroom A, 2nd Floor
Sacramento, CA 95814

Tuesday, October 8, 2024
8:00am – 4:30pm (PT)
Post-Event Networking Reception begins at 4:30pm (PT)

In-person registration has reached capacity, and a waitlist has been enabled.
If you were given an access code, enter it below to be registered.

Registrants who are waitlisted will be moved into active in-person registration on a first-come, first-serve basis. Those who are unable to be accommodated with in-person registration will have virtual access to the event. We apologize for any inconvenience.

Please complete the form below to register and receive periodic updates about the upcoming CA for ALL Ages & Abilities event.

If you have questions or need support with registration, please contact us.

All fields marked with (*) are required and must be filled.

Select Your Registration Type ^*

First Name ^*

Last Name ^*

Email Address ^*

Phone Number ^*

Zip Code ^*

Would you like to share an emergency contact?

Yes

No

(In the event of an emergency during the CA for ALL Ages & Abilities event, the designated individual will be contacted by our staff.)

Emergency Contact's Name ^*

Emergency Contact's Phone ^*

Please select your mode of participation. ^*

Virtual

In-Person (Add Me to Waitlist)

You will be notified via email if an in-person spot becomes available. If an in-person spot does not become available, you will have virtual access to the event. If you were given an access code, please enter it:

Cell Phone / Day-Of Phone ^*

Affiliation / Organization ^* (Please avoid acronyms.)

Foundation ^*

Title ^*

Please upload a short biography that can be used for the program. (Upload only PDF or Word document.)

Please upload a headshot that can be used for the program. (Upload only JPEG or PNG files; keep under 5 megabytes.)

Would you like us to include any support staff in communications related to your speaking engagement? ^*

Yes

No

Please provide an email address for the individual who should be included. ^*

Please select your committee membership below ^*

Alzheimer's and Related Disorders Advisory Committee (ADRD AC)

California Aging and Disability Research Partnership (CADRP)

Disability and Aging Community Living Advisory Council (DACLAC)

Elder and Disability Justice Coordinating Council (EDJCC)

Equity Advisory Committee on Aging & Disability (EACAD)

Implementing the MPA in CA Together (IMPACT) Advisory Committee

Do you have any dietary restrictions or food allergies that should be taken into consideration?

Yes

No

(A light continental breakfast and boxed lunch will be provided to all in-person attendees at no cost.)

Please provide a brief description of your dietary restrictions and/or food allergies. ^*

Send us any comments and questions you might have.

Please let us know if you have any reasonable accommodation requests.

American Sign Language Interpretation

Closed Captioning

Accessible Electronic Materials

Wheelchair / Power Scooter Access

Other

Please let us know how our team can best support you during the event. ^*

Photography / Videography Consent & Release

Check if you consent with the Photography & Videography Agreement. ^*