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Thank you for your interest in attending One Rare Experience 2022: Empowerment, a virtual Zoom Event.

Please fill out this survey to apply for registration.  Also, check out our confirmed speaker list here.

Please note, this is a program for adults living with rare disease aged 18-35.

*The first 50 registrants will receive a care package from One Rare ahead of the program.*

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* 1. One Rare Experience is for people aged 18-35, living with a rare disease indicate yes or no if you meet this criteria.

If you are willing to share your age with One Rare at this time, please indicate in the box below.

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* 2. Would you like to attend One Rare Experience 2022: Empowerment?

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* 3. Do you have access to a device that is able to utilize Zoom platform, Google Chrome browser (free download) and a connection to the internet (e.g. WIFI or wired)?

Note:  One Rare does not want technological barriers to limit participation - we will reach out to you if you indicate 'no' to this question.

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* 4. Please enter your physical address and contact information:

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* 5. Are you able to receive and accept a care package from USPS at the address above? (Care packages include giveaways and relevant information for the program - it is not necessary to receive a care package to participate).

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* 6. Please indicate which days/times you are available to attend? (Select all that apply and note we will have at one or more breaks scheduled each day.)

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* 7. This year's theme is Empowerment and our confirmed speaker and topic list can be viewed here. Are there any events/topics you would like to see added to this or future One Rare Experience programs?

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* 8. Do you have any dietary restrictions? (Select all that apply.)

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* 9. Is Uber Eats available in your area?  If not, can you specify if there is a meal delivery service in your area (e.g. Grub Hub, Door Dash, Seamless, etc).

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* 10. There will be opportunities for pictures, screen shots or quotes to be used in social media platforms promoting One Rare organization and/or events.  

If you are selected to participate in this year's One Rare Experience, do you give consent for use of your likeness (image) or quotes by One Rare?

(Example:  click on link to see a screen shot captured from a previous event on One Rare's home page).

Please let us know if you have any questions or comments in the field below.

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* 11. Are you interested in participating in One Rare Adventure 2022 (an outdoor adaptive camping/kayaking adventure)?  

For any questions, please email info@onerare.org and we will respond as soon as possible.  Thank you! 
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