CHAMP1 Family & Science Conference Guest Information & Preferences Please provide the details below for yourself and anyone else travelling with you, such as family and friends, for the 5th CHAMP1 Family & Science Conference in Rimini, Italy. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastMobile Phone Number *Add Me To The Conference WhatsApp Group *YesNoThis will be used for information in the lead up to, and during the event. You can add relatives into the group once approved.T-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtSize chart is available via the link below.Click Here For T-Shirt Size GuideDo You Have Any Allergies? *Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Are Others Attending With You? *No - Only MeYes - 1 OtherYes - 2 OthersYes - 3 OthersYes - 4 OthersYes - 5 OthersYes - 6 OthersYes - 7 OthersYes - 8 OthersYes - 9 OthersDo You Intend To Use The Free Babysitting/Child-Care Service? *YesNoWhich Airport Are You Landing At? *Flight Arrival Date & Time *DateTimeFlight Departure Date & Time *DateTimeWill You Need To Park A Car At The Conference? *YesNoDo You Have A Disabled Parking Badge/Permit? *YesNo*For somebody travelling in your vehicleOther Attendee 1Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 2Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 3Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 4Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 5Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 6Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 7Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 8Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?Other Attendee 9Name *FirstLastAge *Baby-Sitting/Child-Care Required For This Guest?NoYes - They Have A CHAMP1 DiagnosisYes - They Do Not Have A CHAMP1 DiagnosisT-Shirt Size *Please Choose SizeXSSMLXLXXLXXXL1/2Y3/4Y5/6Y7/8Y9/10Y11/12YI Do Not Want A T-ShirtDo They Have Any Allergies?Please specify severity and any other information, e.g. contamination, airborne, etcSpecial Accommodations?Do you have any special requirements, e.g. wheelchairs, medical needs?EmailSubmit