CROI Hotel Waiver Request Form

Please fill out the form below. You do not need to submit a request if you live within a 50-mile radius of the convention center or are rooming with an approved CROI attendee who booked their room through the official CROI housing system. Please indicate this in the registration system.

Submissions are typically reviewed within 2 or 3 business days. Once a decision has been made, you will be notified via email. Thank you!

X/Twitter
This field is for validation purposes and should be left unchanged.
First Name:*
Last Name:*
Email Address:
Reason for the request:*
Emergency Contact Information
Please provide the following information. We will only use the information below in case of an emergency.
Emergency First Name:*
Emergency Last Name:*
Emergency Email Address:*
Phone Number:*
Address: (Please provide the address of where you will be staying during the conference.)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Admin Notes:

CROI Hotel Waiver Request Form

Emergency Contact Information