Event Consent Forms

Note: Each Participant (adults and children) must complete a separate form. For those completing the form using screen readers, please press x to navigate to the checkboxes or f to navigate to the form fields.

General Release of Liability and Hold Harmless Agreement*
- I/my child(ren) agree to assume all risks and to release, hold harmless, and covenant not to sue the National Federation of the Blind or any designated beneficiaries, sponsors, officers, officials, divisions, affiliates, chapters, communities, organizations, friends of the event, and all other government or public entities and all their respective directors, officers, agents, employees, and members for any claim, loss, or liability that I may have arising out of my participation in the event. I / My child will participate in the event facilitated by the National Federation of the Blind of Illinois, and other divisions, affiliates, and Chapters of the National Federation of the Blind. I / My child will adhere to any and all rules and policies of the Program.
MEDIA RELEASE FORM
- I hereby give permission to photograph me and my child) and to use audio and/or video equipment to record my participation in the event of the National Federation of the Blind of Illinois (“NFBI”), and other divisions, affiliates, and chapters of the National Federation of the Blind. I grant permission to use said photos or recordings to promote the programs of the National Federation of the Blind (“NFB”) and the National Federation of the Blind of Illinois, and other divisions, affiliates, and chapters of the National Federation of the Blind. I also understand that print and visual media may be used to distribute information regarding my and/or my child(ren)’s participation in the program. It is understood that this material will be used solely for educational purposes or to promote the programs of the NFB and NFBI.
National Federation of the Blind CODE OF CONDUCT
- I acknowledge that I have read the National Federation of the Blind Code of Conduct and that I agree to follow its policies, standards, and principles.
National Federation of the Blind Pledge
- I pledge on behalf of myself and my child(ren) to participate actively in the efforts of the National Federation of the Blind to achieve equality, opportunity, and security for the blind; to support the policies and programs of the Federation; and to abide by its Constitution.
Participant's Name*
First Last
Parent / Guardian's Name
if participant is under 18 years of age
First Last

Comments are closed.

Flickr Photostream

_MG_1160

Maurice Paret at the podium during Spring Student Seminar 2019.

PattiChang

Mark Riccobono delivering keynote at Columbia College during our connections luncheon.

A gentleman in a suit and tie standing on a wooden stage behind a purple and grey podium that says "Columbia College Chicago". Above him are some spot lights on a track line and a taupe curtain behind him.

_MG_1013

Audience from the back of the room. Participants are at round tables. We can also see the head table.

P1080403

President Riccobono (second right) is shown with several sponsors and supporters of the event, including left to right, Ed Vitu, Paul Rink, Dr. Janet Szlyk and John Gordon (right). Photo Credit: Dominic Calabrese

P1080401

National Federation of the Blind President Mark Riccobono is shown addressing the NFB session at Columbia College on March 19. Photo Credit: Dominic Calabrese

P1080399

Shown is the President of the National Federation of the Blind of Illinois, Denise Avant, (right) introducing the panel members. Photo Credit: Dominic Calabrese

P1080398

Here is a crowd shot of the event. Attendees are shown enjoying their lunches and socializing at the NFB session held at Columbia College on March 19. Photo Credit: Dominic Calabrese

P1080393

Shown left to right are the speakers at the NFB event on March 19: NFB President Mark Riccobono; Nelly Gamino, parent of Alex Gamino and employee of Advanced Group; and Josh Loevy of Loevy and Loevy. Photo Credit: Dominic Calabrese

P1080387

Luke Scriven, assistive technology manager at The Chicago Lighthouse, demonstrates a new device to a session attendee. Photo Credit: Dominic Calabrese

2019 Washington seminar pictures with Jan Schakowski, Steve, Dustin, and Ellen.

« prev 1 2 3 4 5 6 … 14 next »
(135 Photos)

Latest Facebook Posts

National Federation Of The Blind Of Illinois

9 hours ago

Looking forward to #NFB19 …

View on Facebook

National Federation Of The Blind Of Illinois

1 month ago

HEADS UP (from National Federation of the Blind’s Twitter page): There are only a few days left to preregister for #NFB19. Save some money, and make sure you are with us in Las Vegas at the Mandalay Bay Resort and Casino for the largest gathering of blind people. …

View on Facebook

Calendar of Events

June 1, 2019

Ferris Wheel Chapter Meeting (note room change)

June 1, 2019 @ 1:00 pm - 3:00 pm
Lincoln Library, 326 South 7th, Springfield. in the Carnegie Room South (first floor)

Greater Springfield Area.
Contact chapter president, Bill Reif, for more Info at billreif@ameritech.net or 217-801-2996.
meeting will be accessible also by conference line: 605-313-4819 code N F B I.

June 2, 2019

LIFE Group weekly reading

June 2, 2019 @ 5:00 pm - 6:00 pm
605 313 4819 code 5433 (LIFE)

Please check IL-Talk or with Linda Hendle for any exceptions to the regular weekly schedule.
At Large Chapter Meeting (605 313 4819 code 6324)

June 2, 2019 @ 7:00 pm - 9:00 pm
605 313 4819 code 6324 ( N F B I )

June 8, 2019

Four Rivers Chapter Meeting

June 8, 2019 @ 11:00 am - 1:00 pm
Belleville Public Library, 121 E. Washington St., Belleville, IL 62220

Contact chapter president Brian Sumner for more info (ColaBoy1965@gmail.com 618-236-6310).
Chicago Chapter Board meeting

June 8, 2019 @ 11:30 am - 12:30 pm
Exchequer Pub (prior to Chapter meeting)
Blackhawk Chapter Meeting

June 8, 2019 @ 1:00 pm - 3:00 pm
Hope Creek Care Center, 4343 Kennedy Drive, East Moline, IL

call-in option:
6 0 5-3 1 3-4 8 1 9

code: "HAWK" (4 2 9 5)

Chapter president, Patrick Olson, 309-592-1313
Chicago Chapter Meeting

June 8, 2019 @ 1:00 pm - 4:00 pm
Exchequer Restaurant & Pub, 226 S. Wabash, Chicago, http://exchequerpub.com/menu/

meetings chaired by Chapter President Steve Hastalis (Steve.Hastalis@GMail.com).

June 9, 2019

LIFE Group weekly reading

June 9, 2019 @ 5:00 pm - 6:00 pm
605 313 4819 code 5433 (LIFE)

Please check IL-Talk or with Linda Hendle for any exceptions to the regular weekly schedule.
IABS Board Teleconference (code IABS)

June 9, 2019 @ 7:00 pm - 8:00 pm
605 313 4819 code 4227 (IABS)

June 10, 2019

NFB BELL Academy - Springfield

June 10, 2019 @ 8:30 am - June 14, 2019 @ 3:30 pm
First Christian Church 700 S. Sixth St. Springfield, IL 62703

To learn more about NFB BELL Academy and to apply please visit
https://nfb.org/bell-academy

June 11, 2019

NFB BELL Academy - Springfield

June 10, 2019 @ 8:30 am - June 14, 2019 @ 3:30 pm
First Christian Church 700 S. Sixth St. Springfield, IL 62703

To learn more about NFB BELL Academy and to apply please visit
https://nfb.org/bell-academy

June 12, 2019

NFB BELL Academy - Springfield

June 10, 2019 @ 8:30 am - June 14, 2019 @ 3:30 pm
First Christian Church 700 S. Sixth St. Springfield, IL 62703

To learn more about NFB BELL Academy and to apply please visit
https://nfb.org/bell-academy

June 13, 2019

NFB BELL Academy - Springfield

June 10, 2019 @ 8:30 am - June 14, 2019 @ 3:30 pm
First Christian Church 700 S. Sixth St. Springfield, IL 62703

To learn more about NFB BELL Academy and to apply please visit
https://nfb.org/bell-academy

June 14, 2019

NFB BELL Academy - Springfield

June 10, 2019 @ 8:30 am - June 14, 2019 @ 3:30 pm
First Christian Church 700 S. Sixth St. Springfield, IL 62703

To learn more about NFB BELL Academy and to apply please visit
https://nfb.org/bell-academy

June 16, 2019

LIFE Group weekly reading

June 16, 2019 @ 5:00 pm - 6:00 pm
605 313 4819 code 5433 (LIFE)

Please check IL-Talk or with Linda Hendle for any exceptions to the regular weekly schedule.

June 22, 2019

Blackhawk Bowling Event

June 22, 2019 @ 11:20 am - 1:20 pm
QC Family Entertainment Center, 4401 44th Ave., Moline, IL

Participants will need to pay $3.49 for shoes and pay for whatever food they want. Lane costs will be covered by the chapter.
HAVE QUESTIONS?
Contact the chapter president, Patrick Olson, at 309-592-1313.

June 23, 2019

LIFE Group weekly reading

June 23, 2019 @ 5:00 pm - 6:00 pm
605 313 4819 code 5433 (LIFE)

Please check IL-Talk or with Linda Hendle for any exceptions to the regular weekly schedule.

June 29, 2019

Chicago Chapter Bowling

June 29, 2019 @ 6:00 pm - 9:00 pm
Fireside Lanes, 2646 West Fullerton, Chicago

June 30, 2019

LIFE Group weekly reading

June 30, 2019 @ 5:00 pm - 6:00 pm
605 313 4819 code 5433 (LIFE)

Please check IL-Talk or with Linda Hendle for any exceptions to the regular weekly schedule.