Exhibitor Application Form

Miami Neuroscience Symposium, Tenth Annual

Company/Contact Information

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Please list your company name as it should appear in acknowledgements.
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First Contact
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Payment Details

Exhibit Hall Rate

Online Participation

  • $25,000 (Platinum Supporter)
  • $15,000 (Gold) Supporter)
  • $10,000 (Silver Supporter)
  • $5,000 (Bronze Exhibitor)

In-Person Participation

  • $25,000 (Platinum Supporter)
  • $15,000 (Gold) Supporter)
  • $10,000 (Silver Supporter)
  • $5,000 (Bronze Exhibitor)
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Important: Next Steps

Your payment is for a Bronze exhibit.

Check Payments

To make a check payment, please contact Julie Zimmett and submit a check payable and mailed to the following address:

Baptist Health CME Department (Tax ID Number 65-0267668)
Attn: Julie Zimmett
8900 N. Kendall Drive, Miami, FL 33176

Credit Card Payments

You will be prompted to complete your credit card payment on the next page.

Baptist Health Foundation - Corporate Philanthropy Partners

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If you would like more information about becoming a Corporate Philanthropy Partner of Baptist Health Foundation, please contact Megan Cottle at MeganCo@BaptistHealth.net or 786-467-5534.

Important: Next Steps

Your payment is for Platinum, Gold, or Silver support.

Check Payments

To make a check payment, please contact Megan Cottle and submit a check payable and mailed to the following address:

Baptist Health South Florida Foundation (Tax ID Number 59-1923401) 
Attn: 2022 Miami Neuroscience Symposium
6855 Red Road, Coral Gables, FL 33143

Credit Card Payments

To make a credit card payment, please contact Megan Cottle.

COVID-19 Protocols Notice For All Attendees

Baptist Health South Florida’s Continuing Medical Education department will implement health-and-safety protocols appropriate to the public health circumstances existing at the time of CME conferences in accordance with the World Health Organization, CDC, Baptist Health, and other key regulatory agencies. These protocols include, but are not limited to,

  • proof of negative COVID-19 status and/or vaccination
  • self-monitoring
  • active screening
  • contact tracing
  • wearing a mask
  • use of additional personal protective equipment, social distancing and space management
  • avoidance of physical contact, such as handshaking and embracing

Compliance with some or all of the protocols adopted by BHSF may be mandatory for in-person attendance at the conference. If there is additional information regarding health and safety measures, and any necessary consents by you, we will contact you prior to the start of the first day of the conference.

I have read and understand Baptist Health’s CME COVID-19 protocol requirements to attend in-person events.

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Enter your full name.

Terms and Conditions

For the purpose of this agreement, “Exhibitor” refers to the company(ies) represented at this event as well as the companies’ representative(s) present at this event; and “Baptist Health” refers to Baptist Health South Florida, its affiliates, subsidiaries, contractors, departments and/or employees.

  • Subletting of exhibit space is not permitted.
  • Baptist Health will not refund any fees paid under this agreement if the company cancels or does not use the exhibit space.
  • Baptist Health CME reserves the right to (a) reject any exhibit application; (b) reject, prohibit, restrict or otherwise require modification of any exhibit for any reason; and (c) ban any exhibitor whose exhibit, materials or conduct is objectionable for any reason.
  • Violation of any regulations on the part of the exhibitor, its employees or agents shall void the right to be included in the virtual exhibit hall, and such exhibitor will forfeit to Baptist Health CME all monies they may have paid.
  • Exhibitor shall release and hold harmless and indemnify Baptist Health from any and all claims, obligations, liabilities, causes of action, lawsuits, damages and assessments, including legal fees, that result from an allegation of negligence on the part of the exhibitor or Baptist Health or third parties in the use of the exhibit space or activities in connection with the use of the exhibit space.
  • Note: The format of all events are subject to change. All events will take place in a safe and physically distant format that follows established recommendations by the CDC and Baptist Health South Florida policies.

Special Accessibility Needs

In accordance with the Americans with Disabilities Act, Baptist Health CME will make all reasonable efforts to accommodate persons with disabilities at this symposium. Please contact Julie Zimmett if you require special accomodations.

Agreement

I have read and I agree to the Terms and Conditions for Baptist Health CME Exhibit Hall Participation for the Miami Neuroscience Symposium, Tenth Annual.

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Enter your full name.