The death, injury, or illness happening to the attendee or exhibitor or a member of their immediate family who is under the age of 70.

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1. Contact Information (Required.)

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2. Name of Registration Purchaser (Required.)

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3. Registration Price Paid (in USD) (Required.)

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4. Registration Number (Required.)

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5. Date Purchased (Required.)

Date

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6. When did you become aware that you would not be able to attend the Event Please provide all details. (Required.)

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7. Please be advised we require a death certificate or doctor’s note confirming the details. Upload the required documents below. (Required.)

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8. Name of person who suffered the death, injury or illness. (Required.)

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9. Relationship to you. (Required.)

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10. Nature of accident or illness. (Required.)

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11. If illness, when was it first diagnosed? (Required.)

Date

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12. If accident, how and when did the accident occur? (Required.)

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13. Why did this incident prevent this person from attending the event? (Required.)

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