PAAO 2025 – Congress Super Early Registration

BY SUBMITTING THIS FORM, I AGREE THAT I HAVE READ AND FULLY UNDERSTOOD IT, AND I AGREE THAT EACH OF THE FOLLOWING STATEMENTS ARE TRUE:

1. All information submitted on or in support of this application is true, accurate, and complete.
2. I understand and agree that all such information is subject to review and verification by or under the supervision of the Board of Directors of the Pan-American Association of Ophthalmology ("PAAO").
3. I authorize and consent to that review and verification and all inquiries and good faith disclosures about me that may be made in the course of that verification process.
4. I authorize all persons who have information about me to report such information to the PAAO.
5. I hereby waive and release, indemnify, and hold harmless the PAAO and its Members, Directors, officers, employees, and representatives, the endorsers of this application, and all other persons and entities, or any of them, seeking, obtaining, providing, disclosing or acting upon any such information about me, from, against, and with respect to any and all claims, losses, costs, expenses, damages, liabilities, and judgments of any kind arising, or alleged to have arisen, out of, with respect to, or in any connection with seeking, obtaining, providing, disclosing, or acting upon any such information.
6. I agree to comply with the PAAO's Code of Ethics as a condition of initial and continued membership in the PAAO.
7. I understand and agree that my continued status as a Member will be subject to all of the terms and conditions of the Bylaws of the PAAO and that the Board of Directors of the PAAO may revoke my membership if this application contains or is supported by information that omits or contains a substantial misstatement of any fact required or permitted by this application or the related instructions to be included on or submitted with or in support of this application.

The Pan-American Association of Ophthalmology does not discriminate in membership as to race, national origin, religion, creed, gender or sexual preference.