2023 Annual Scientific Meeting | Family Care Access Form

The GSA 2023 ASM will be hosting a Family Care Room at the Tampa Convention Center for the duration of the conference. This room will be available to those who need a safe space for children while they attend a session or event. This area will be monitored by security and will require a sign-up for use.

Please complete the from below to gain access to the family care room during the ASM. Proof of identity will be required at the time of check-in.

Section I: Name and Contact Information (Parent)

Attendee Full Name (as it will appear on your GSA 2023 badge) *

Attendee Contact Number *

Section II: Name and Contact Information (Caregiver)

Children must be accompanied by an adult (18 or over) during their time in the family care room and must never be left unattended. Please provide the name and contact infomation of the caregiver that will be present with your child. If the caregiver is the same as the "Attendee", please provide those details again below.

Caregiver Full Name *

Caregiver Contact Number *

Section III: Name and Age of Children

Please provide the name and age of your child (children) accessing the family care room.

Child Name (1) *

Age (1) *

Child Name (2)

Age (2)

Child Name (3)

Age (3)

As the ASM attendee and parent, I acknowledge the rules of use for the family care room. *

Yes

Be sure to click Submit in order to receive a confirmation of your submission. If you do not receive a confirmation, please notify meetings@geron.org.