Jump to content

2026 ABOG Simulation Summit

2026 Simulation Summit Application Form

 

Please note: ABOG does not provide or supply surgical, medical, or other equipment. If your model or demonstration requires specific equipment or devices, please ensure you bring all necessary items with you. 

 

 
 

Speaker Disclosure and Media Consent 

 

Please note: Completion of the speaker disclosure and media consent is part of the application process and does not indicate speaker selection. If you have any questions, please contact communications@abog.org.  

 
Photography and Recording: In exchange for good and valuable consideration acknowledged as sufficient and received by me, I grant ABOG the right to photograph and record me, including my name, image, likeness, appearance, and voice, and my presentation (collectively referred to as the “Recording”), including any discussion or visuals and the information contained therein (collectively referred to as the “Presentation”), during the 2026 ABOG Simulation Summit. *
 
License: In exchange for good and valuable consideration acknowledged as sufficient and received by me, I grant ABOG a limited, non-exclusive, non-revocable, perpetual, royalty free, sublicensable, transferable, and worldwide license (“License”) to digitize, modify, create derivative works from, display, distribute, reproduce, and otherwise use the Recording and the Presentation in any media by any means delivery as deemed appropriate by ABOG solely for education or promotional purposes associated with ABOG, including distribution to Summit attendees and ABOG. I acknowledge and agree that ABOG is the sole and exclusive owner of the Recording and that no provision in this Presenter Disclosures and Permissions Agreement (“Agreement”) shall be deemed to convey or transfer to me any right, title, or interest in or to the Recording. I hereby irrevocably assign to ABOG all my right, title, and interest, if any, in and to the Recording. *
 
Tagging: In exchange for good and valuable consideration acknowledged as sufficient and received by me, I grant ABOG permission to “tag” me on any social media platform utilized by ABOG. *
 
Author of Presentation: I represent and warrant that I am the author of the Presentation in whole or in part. I further represent and warrant that I have the right to grant the License and that the License does not infringe upon any copyright, trademark, trade secrets, or other intellectual property proprietary rights of any third party. In exchange for good and valuable consideration acknowledged as sufficient and received by me, I agree to defend, hold harmless, and indemnify ABOG, its past, present, and future subsidiaries, affiliates, their collective past, present, and future members, managers, directors, officers, volunteers, employees, and agents (collectively referred to as the "ABOG Indemnified Parties") from and against any allegation, charge, claim, cause of action that the Presentation or the Recording infringes upon the intellectual property proprietary rights of any third party (i.e., a third-party infringement claim), including related costs, damages, losses, reasonable attorney's fees, and other liabilities of any nature. *
 
Release and Waiver: In exchange for good and valuable consideration acknowledged as sufficient and received by me, I release the ABOG Indemnified Parties from and waive all allegations, charges, claims, and causes of action against the ABOG Indemnified Parties related to or arising out of all affirmations and representations herein. *
 
Cancel or Modify: I agree that ABOG has the right to cancel or request modifications to the Presentation and that ABOG will provide as much notice as is reasonably practicable in the event of any cancellation or modifications. *
 
Submission: I agree that I have reviewed and understand the affirmations and representations contained herein. By checking the box labeled “Agree” and typing my name and date below, I agree to submit this as completed by me by electronic means. *
 
 

Simulation Model Details

Type of Simulation Model and Clinical Relevance:
 
Purpose of the Model:
 
Simulation Setup Requirements:
 
Required Resources:
Please note: ABOG does not provide or supply surgical, medical, or other equipment. If your model or demonstration requires specific equipment or devices, please ensure you bring all necessary items with you. 
 
Reproducibility and Scalability:
 
Simulation Duration:
 
Research and Validation:
If you have supporting publications, please attach them as PDFs in the field below. Each file must not exceed 25 mb.

This field is required

Add another
 
Strengths and Limitations:
 
Cost Estimate:
 
 

Supplemental Materials

Images of the Model:
Upload clear photographs of the simulation model. Accepted file formats: .jpg, .jpeg, or .png only. *

This field is required

Add another
 
Demonstration Video:
 
 

Simulation Model Disclosure and Compliance

Patent or Intellectual Property Considerations:
 
Conflicts of Interest and Industry Involvement: