Speaker Submissions

Name(required)

Email(required)

Organization(required)

Licenses/Certifications(required)

Professional Biography(required)

Resume URL(required)

Headshot URL(required)

Presentation Type(required)

Whiteboard Lecture Hands-on Workshop High-fidelity Simulation

Presentation Length(required)

1 hour 2 hours

Presentation Title(required)

Presentation Objectives (minimum of 4 for every 1 hour of material)(required)

Presentation Description(required)

Presentation Materials URL (if applicable)

Required Equipment (if applicable)

Are you providing required equipment? (if applicable)

Yes No

Do you have a co-speaker?(required)

Yes No

Co-Speaker Name

Co-Speaker Email

Co-Speaker Organization

Co-Speaker Licenses/Certifications

Co-Speaker Professional Biography

Co-Speaker Resume URL

Co-Speaker Headshot URL

I certify that the facts I state during my presentation are true to the best of my knowledge and belief.(required)

Yes

I certify that I will disclose any direct or indirect conflicts of interest that arise from my participation in Crash and Learn 2023.(required)

Yes

I understand that Crash and Learn 2023 is an exclusively outdoor conference. I understand that slide presentations are not allowed, and electricity will not be available.(required)

Yes

I understand that I am committing to speak at Crash and Learn 2023 and allowing my information and likeness to be used in promotions of this conference.(required)

Yes

I certify that Heavy Lies the Helmet, LLC may use such photographs or videos of me, my family, and my property with or without my name and for any lawful purpose, including such purposes as publicity, illustration, advertising, and web content for monetization.(required)

Yes

Submission Form