Submit Your Photo - World Parkinson Coalition

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Submit Your Photo

First Name *
Last Name *
City *
Country *
Email Address *
Description of photo
Attending WPC 2022 *	YES- I will attend the WPC 2022 MAYBE- I hope to attend the WPC 2022 NO- I will not attend the WPC 2022
Attended WPC 2019 *	YES- I attended the WPC 2019 NO- I did not attend the WPC 2019
Permission for use *If you give permission for the WPC to use your photo on its website, click YES. If you do not give permission for the WPC to use your photo on its website, click NO.	YES - the WPC may use my photo on its website NO - the WPC may NOT use my photo on its website
Upload Photo *

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