ACM Empowering Educators DEI Event Step 1 of 2 50% The ACM Empowering Educators DEI Event is set to take place at Lake Forest College on July 17th and 18th. Please complete this RSVP form no later than June 24th, 2024.Name(Required) First Last Email(Required) Mobile Phone(Required) Title(Required) Institution(Required)ACMBeloit CollegeCarleton CollegeCoe CollegeColorado CollegeCornell CollegeGrinnell CollegeKnox CollegeLake Forest CollegeLawrence UniversityLuther CollegeMacalester CollegeMonmouth CollegeRipon CollegeSt. Olaf CollegeI will attend the Empowering Educators Event:(Required) Yes No Please let us know below in comments if you are only able to attend on certain days or times.I would like a room booked on my behalf Wednesday night, July 17(Required) Yes No Please let us know below in comments if you require and additional night, and for what reasonFrom the hotel to Lake Forest is roughly a 20 minute drive. Will you have a vehicle that can take you to/ from campus?(Required) Yes, I have a vehicle and I will be the driver Yes, I have access to a vehicle through a colleague who I will ride with No, I do not have a vehicle or know of anyone with a vehicle If you answered, “Yes, I have a vehicle and I will be the driver”, please indicate in comments below if you have any unclaimed seats in your vehicle and are willing to let other attendees of this event ride shareI will attend the following meals:(Required) Breakfast on July 17 Lunch on July 17 Dinner on July 17 Breakfast on July 18 Lunch on July 18 Please list any dietary restrictions or food allergies (if applicable). Please list any accommodations you may need at the venue (nursing room, wheelchair accessible bathroom, etc.) or at the hotel Comments (examples: I can only attend the first day,etc.) Associated Colleges of the Midwest (ACM) Media Release FormThank you for your participation in an ACM-related activity. On occasion, representatives from the ACM may wish to photograph, record video and/or audio, and/or interview those connected with our organization. As a nonprofit educational consortium, our goal is to highlight and showcase the work we are doing via our website, videos, emails, posters, brochures, social media, and other marketing materials. As a participant in an ACM activity, your likeness may be captured in photos, videos, or other mediums during the activity. Photos are typically posted directly to the ACM website and/or social media platforms and may also be used in publications such as brochures, flyers, and annual reports. Video content is typically posted on the ACM YouTube channel and embedded into the ACM website. Video content may or may not include captions or written transcriptions. Please complete the waiver below to confirm whether or not you give ACM your permission to use your name and likeness for the purposes described above. While our goal is to post as much web content as possible related to ACM activities, we also respect your right to privacy. Thank you for your cooperation and support. If you have any questions, please contact acm@acm.edu. I give the Associated Colleges of the Midwest (ACM) irrevocable right to use my name and likeness in any photograph, video, audio recording, or other medium in which I appear and for any lawful purpose, including illustration, promotion, advertising, or web content. I understand that these mediums may be edited, copied, exhibited, published, or distributed, and I waive the right to inspect or approve the finished product, including written material that may be created in connection therewith. I also waive any rights of compensation or ownership thereto. It is understood that my participation in these photographs and recordings is done of my own free will. By signing this form, I acknowledge that I have read and fully understand this release, and agree to be bound thereby. I hereby release ACM from any and all claims or liability arising from, or in connection with, ACM’s use of my likeness in these images or recordings.(Required) a. Yes, I agree to the above statement. b. I agree to the above statement but with the exception of the following (please specify below): c. No, I do not agree to the above statement. If you answered "b" to the question above, please explain your answer here. Full Name(Required) Date(Required) MM slash DD slash YYYY Electronic Signature Agreement(Required) I accept. I do not accept. By selecting the “I accept” button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.Untitled Untitled Δ
