Basic information

Email address

Name

Gender

Country

Affiliation (please provide name and contact details of your organisation) (if not applicable: “other”)

Professional/educational background (if not applicable: “other”)

If you have replied other, please specify here

Main area of work (if not applicable: “other”)

If you have replied other, please specify here:

What kind of institution/agency do you work for? (if not applicable: “other”)

If you have replied other, please specify here:

Information relating to attendance

Can you confirm your attendance at the gender and drugs symposium in Lisbon, on 22 October 2024, prior to Lisbon Addiction?

☐ Yes

☐ No

What are your main motivations to attend the side event on gender and drugs?

What are you expecting from this event

Have you previously attended a Lisbon Addictions conference ?

☐ Yes

☐ No

Will you attend the event on women and prison on 21/10/2024 afternoon?

☐ Yes

☐ No

Data protection

I understand that the EUDA will disseminate the video recording and photographs from the Symposium to third parties. I acknowledge that these documents are following the Data Protection and Confidentiality Rules set by the Regulation (EC) No 45/2001, and violating this grants the EUDA the right to further processing on serious and legitimate grounds

☐ Yes

☐ No

I hereby declare I willingly agree to be photographed and/or filmed by the contractor of the European Monitoring Centre for Drugs and Drug Addiction (EUDA) during the Symposium 2024 edition

☐ Yes

☐ No

In order to illustrate or promote the activities or projects, past, present or future, of the European institutions and the European Union, I authorize the EUDA (please check the box if you authorize)

☐ Yes

☐ No

I hereby give my consent to the processing of my personal data to the extent necessary for the achievement of the purposes mentioned above. The EUDA guarantees that personal data relating to me are processed according to the rules set by the Regulation (EC) No 1725/2018. Data may be archived by the EUDA.

☐ Yes

☐ No

Authorisation for the taking and sharing of (please check the boxes you authorize):

☐ Pictures

☐ Video content

☐ Presentation Materials: If participants will be presenting at the conference (e.g., giving talks, posters), permission to distribute or share their presentation materials (slides, abstracts) with attendees or online

☐ Feedback and Testimonials: provide feedback or testimonials about their conference experience, which may be used for testimonials on your conference website or promotional materials

☐ Biographical Information:  permission to include participants' biographical information (e.g., professional background, interests) in conference materials such as programs or online profiles

I understand that I have the right, as data subject, to access data relating to me, to be informed about the existence and the extent of data processing, to rectify incorrect personal data as the case may be and to oppose further processing on serious and legitimate grounds. To exercise these rights, please contact the EUDA at the following address: [email protected] In addition, you may also contact the European Data Protection Supervisor (EDPS) at the following address: [email protected].

☐ Yes

☐ No

This authorization shall apply worldwide and for as long as my image is subject to legal protection. It can be withdrawn by informing the EUDA at the following address: [email protected]

☐ Yes

☐ No