• NOTICE:

  OMB Control Number: 0925-0740
  Expiration Date: 09/2025
  Public reporting burden for this collection of information is estimated to average 3 minutes per response, including the time to for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 2892-7974. ATTN: PRA (0925-0740). Do not return the completed form to this address.
  
  This website is not government-owned. Collected identifiable information will be used by symposium organizers to contact you (name and email address) and in the finished publicly-available symposium abstract booklet (name and institution(s)). By using this third-party application, you may be providing nongovernmental third-parties access to your information. The official program website can be found at https://commonfund.nih.gov/highrisk. For more information on our privacy policy, see https://www.nih.gov/web-policies-notices.

• Name

  Name * First Last
• Email *
• Institution/Affiliation *
• HRHR Association *
  Pioneer Awardee New Innovator Awardee Transformative Research Awardee Early Independence Awardee NIH Staff Member of the Public (i.e., lab personnel, students, postdocs, potential applicants, etc.)

• Photography and Recording Notice

  Photography and Recording Notice (this does not apply to presentations or posters, which will not be photographed or recorded): Photography, video recording, and audio recording may occur at the High-Risk, High-Reward Research Symposium. By attending, you consent to photography, audio recording, video recording and their release, publication, exhibition, or reproduction for any purpose(s) that the National Institutes of Health (NIH) deems fit. You release NIH and each and all persons involved from any liability connected. By entering the event premises, you waive all rights you may have to any claims for payment or royalties in connection with any use of these materials. You also waive any right to inspect or approve any photo, video recording, or audio recording taken by NIH or the person or entity designated to do so by NIH.

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