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* 1. Please enter the information for the presenter:

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* 2. Abstract Title

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* 3. Do you want to be considered for a poster or short talk. Select all that apply:


NOTE THAT THE DEADLINE FOR CONSIDERATION FOR SHORT TALKS HAS ALREADY PASSED. ABSTRACTS SUBMITTED AFTER JUNE 24, 2024 WILL ONLY BE CONSIDERED FOR THE POSTER SESSION

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* 4. File upload

DOC, DOCX file types only.
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* 5. By submitting this form, I agree to the Terms and Conditions as outlined in the abstract submissions guidelines for the "Understanding and Preventing Hypoglycemia in Diabetes" meeting

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* 6. By submitting your information via this form, you consent to Helmsley using such information to communicate with you regarding your abstract, as well as the "Understanding and Preventing Hypoglycemia in Diabetes Symposium" hosted by Helmsley, the purpose of which is to provide you with the event information as it becomes available, as well as distribute the collected abstracts and a link to the virtual recording of the event. Should you wish to have Helmsley correct, delete, or restrict the use of this data, you may submit such request to website@helmsleytrust.org.

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* 7. Participant Consent and Release Agreement:

Please check the box below to indicate your acceptance of the following terms regarding the use by Helmsley of any photographs or video or audio recordings made in connection with the event in which you (the “Participant”) are included.

You hereby consent to the photographing and video and audio recording, in any and all media now known or hereafter devised, by Helmsley, Helmsley’s grantees, third parties connected to the Helmsley, or third parties acting on behalf of Helmsley and Helmsley’s grantees, of your voice, actions, likeness, name, and appearance (collectively, “Likeness”). You hereby grant Helmsley, its grantees, and third parties connected to the Helmsley, a perpetual, non-exclusive, worldwide, royalty-free sublicensable right and license to use your Likeness in any and all media now known or hereafter devised in connection with Helmsley and Helmsley’s grantees and any promotion, publicity, marketing or advertisement for or relating to Helmsley and Helmsley’s grantees. You agree that Helmsley and its grantees may use all or any part of your Likeness and may alter or modify it, regardless of whether or not you are recognizable.

You hereby release Helmsley, its grantees, and its and their successors and assigns, and its respective officers, trustees, employees, authorized representatives, agents and assigns and any designee (including without limitation any agency, client, broadcaster, periodical or other publication) from any and all claims arising from the use of your Likeness, including any claims for defamation or invasion of privacy.

This Agreement will be governed by New York law. You, the Participant, represent that you are at least 18 years old and are signing on your own behalf.

 
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