Participant – Event Registration Form Step 1 of 3 33% Contact DetailsSummit Location(Required)Select the Summit Location you would like to register for.Full Cycle: 2025 Virtual WIND Summit (Virtual)2025 Miami WIND Summit (Miami, Florida, USA)2025 La Paz Summit (La Paz, Mexico)Marcabelí Circular (Marcabelí, Ecuador)BreatheBlue Youth Summit (New Delhi, India)2025 Ghana Wind Summit (Accra, Ghana)Fortaleza Sustentável (La Fortaleza, Brazil)Limbe WIND Summit (Limbe, Cameroon)The Kijiji Circularity Summit (Mombasa County, Kenya)Narok WIND Summit (Narok, Kenya)Nairobi Wind Element Summit (Nairobi, Kenya)WIND SUMMIT 2025 ELDORET! (Eldoret, Kenya)Kaduna Circular Solutions Summit (Zaria, Kaduna, Nigeria)Ogun State Wind Summit (Ado-Odo Ota, Ogun State, Nigeria)JOS Wind Summit 2025 (Jos Plateau State, Nigeria)Closing the Loop (Akoka, Lagos, Nigeria)Vanguard 2025 Wind Summit (Musanze, Northern Province, RwandaKIGALI 2025 WIND SUMMIT (Kigali, Rwanda)2025 WIND Summit (Kaur, Central River Region, Banjul, The Gambia)Brikama Wind Summit 2025 (Brikama Santa Su, The Gambia)The Winds of Change: Tackling Plastic Pollution (Ndemban, The Gambia)Youth Led Action Against Plastic Pollution (Banjul Sinchu Baliya, West Coast Region, Gambia)Name(Required) First Last Gender(Required)MaleFemaleNon-binaryAgenderMy gender isn't listedPrefer Not to AnswerPronounsEmail(Required) Enter Email Confirm Email Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone(Required)Date of Birth(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age(Required)Parent/ Guardian Name(Required) First Last Parent/ Guardian Name Email(Required) Event DetailsWhat is your T-shirt size?(Required)XSSMLXLXXLHow did you hear about this event?(Required)Social MediaPlaneteerHQFrom the Summit HostReferred by a friendFrom an OrganizationOtherName of OrganizationAre you a member of PlaneteerHQ?(Required)PlaneteerHQ is Planeteer Alliance’s online community platform! If you are not already on the site, you will be emailed information about joining.Yes!Not yetIs there any additional information you'd like to provide for your host(s) or Planeteer AllianceEx: Medical conditions, accommodations if needed Participant SafetyEmergency Contact NameEmergency Contact Phone NumberConsent(Required)PLANETEER ALLIANCE EVENT PARTICIPATION AGREEMENT & RELEASE Sponsored by Young Heroes, LLC (a subsidiary of Captain Planet Foundation) PLEASE READ CAREFULLY This Participation Agreement (“Agreement”) is entered into by and between Young Heroes, LLC, a wholly owned subsidiary of the Captain Planet Foundation, and: The individual attending the event (Participant), and If Participant is under eighteen (18) years of age, their Parent or Legal Guardian (“Parent/Guardian”). This Agreement governs participation in any in-person or virtual event organized, hosted, or sponsored by Young Heroes, LLC or the Planeteer Alliance (“Planeteer Alliance Event”). 1. EVENT SCOPE & ELIGIBILITY This Agreement applies to all official Planeteer Alliance Events. Events may include Summits, Meetups, conferences, workshops, or training programs. Participation is by invitation or application and limited to youth ages 10 to 25. Events are provided at no cost to participants, though travel, accommodations, meals, and incidentals may be the responsibility of the Participant unless otherwise specified in writing. This Agreement must be completed and submitted before a Participant may attend. 2. CODE OF CONDUCT Participants agree to uphold a high standard of conduct during the event. By signing this Agreement, the Participant agrees to: Be respectful and inclusive of all individuals regardless of background or identity. Refrain from harassment, bullying, hate speech, or any discriminatory behavior. Not engage in illegal activity, underage drinking, use of illegal substances, or disruptive behavior. Follow all safety rules, event staff directions, venue regulations, and curfews (where applicable). Not leave the event premises or group without prior approval from event staff. Violation of these expectations may result in immediate removal from the event and/or future disqualification from Planeteer Alliance programming. 3. TRAVEL, LODGING, AND MEALS Unless otherwise stated: Participants and their families are responsible for making and paying for travel arrangements. Young Heroes and Captain Planet Foundation are not liable for missed flights, lost luggage, or other travel-related issues. If lodging or meals are provided, they will be arranged in advance and communicated clearly to Participants. Participants are responsible for bringing any necessary items such as medication, personal care items, or identification. 4. HEALTH & SAFETY Participants (and Parents/Guardians for minors) must disclose any relevant medical conditions, allergies, or accommodations needed before the event. In case of a medical emergency, event staff may seek emergency medical treatment on behalf of the Participant. Young Heroes and Captain Planet Foundation are not responsible for any medical expenses incurred during or after the event. COVID-19 Notice: By attending, the Participant acknowledges the risk of exposure to COVID-19 and agrees to follow all event-related safety protocols. The Participant waives all liability related to exposure to COVID-19. 5. MEDIA RELEASE Participant and/or Parent/Guardian grants Young Heroes, LLC, Captain Planet Foundation, and affiliates the right to record and use: Participant’s name, image, voice, likeness, and/or biographical information In photos, videos, or audio recordings taken during the event These materials may be used for educational, promotional, or archival purposes in any format now or in the future, without compensation or approval rights. 6. PRIVACY & COMMUNICATION Young Heroes will collect limited personal information for event planning and safety purposes, including but not limited to: Name, age, contact details, emergency contacts, and health disclosures (if applicable) Information will be stored securely and used solely for event purposes. It will not be shared or sold to third parties, except when necessary for program delivery or required by law. 7. RELEASE OF LIABILITY In exchange for participation in the event, the Participant (and Parent/Guardian if under 18) voluntarily agrees to: Waive and release Young Heroes, Captain Planet Foundation, and all related staff, agents, and volunteers from liability for any injury, illness, loss, or damage incurred during or in connection with the event Assume all risks associated with travel, group activities, or participation in physical or educational programming Indemnify and hold harmless Young Heroes, Captain Planet Foundation and related parties from any claims arising from Participant’s conduct This release does not apply to liability resulting from gross negligence or willful misconduct by Young Heroes or its representatives. 8. TERM AND TERMINATION This Agreement is effective upon submission and acceptance and remains in effect through the duration of the Participant’s involvement in the Planeteer Alliance Event. Young Heroes and Captain Planet Foundation reserve the right to terminate a Participant’s involvement at any time for violation of this Agreement or for conduct deemed unsafe or inconsistent with the values of the organization. 9. ENTIRE AGREEMENT & MODIFICATIONS This document constitutes the entire Agreement between the parties with respect to the subject matter herein and supersedes any prior written or oral agreements. Young Heroes reserves the right to update or modify this Agreement at any time. Participants will be notified of any significant changes. Continued participation constitutes acceptance of any revised terms. BY SIGNING BELOW, the Participant (and Parent/Guardian, if applicable) acknowledges that they have read, understood, and agreed to all terms and conditions outlined in this Agreement. Participant Information Full Name: ___________________________________________ Date of Birth: _________________________________________ Phone Number: _______________________________________ Email Address: ________________________________________ Emergency Contact Name & Phone: _______________________ Medical Conditions or Accommodations Needed (if any): SIGNATURES Participant Signature: ________________________ Date: ___________ If under 18 years of age: Parent/Guardian Name: _________________________________ Parent/Guardian Signature: _____________________ Date: ___________ I certify that I have read and agree to the contents of the Planeteer Alliance Event Participation Agreement & Release.Signature