Apply for Children's Congress - Breakthrough T1D Children's Congress

Apply for Breakthrough T1D 2027 Children’s Congress

Applications for Breakthrough T1D 2027 Children’s Congress must be submitted no later than Monday, November 30, 2026 at 11:59 PM HST. Applications submitted after this deadline will not be considered. The use of artificial intelligence (AI) tools to complete any portion of the application, including your letter, is prohibited.

This application may take families more than an hour to complete so please allocate sufficient time, and we recommend working on the application from a laptop or desktop computer.

If you need to leave the application idle for more than 15 minutes, click ‘Save for Later’ to avoid losing your data. You can resume later via the unique link provided on-screen and via email.

Please review the Breakthrough T1D 2027 Children’s Congress Applicant FAQ before starting the application.

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1Child Info

2Parent Info

3Engagement

4Confirm & Submit

Parent Information

If your child is selected as a Delegate, BT1D will cover the cost of one parent/guardian to attend BT1D 2027 Children’s Congress.

Parent's First Name*

Parent's Last Name*

Parent's Email*

Parent's Phone*

Address*

No PO Boxes – actual home address required for determining Congressional District

Street Address Apt / Suite / Other City State ZIP Code

Congressional District*

State

District

Representative

Chapter*

Based on your address

Mailing Address

Check here if your mailing address is different than your home address

Mailing Address

Street Address Apt / Suite / Other City State ZIP Code

Are you currently, or have you previously been, involved with another Breakthrough T1D Chapter?*

Yes

Select the additional Chapter you are affiliated with*

Please provide any comments you have regarding your affiliation with the additional Chapter indicated above.

By signing the below, as the parent/guardian of the applicant submitting this application I acknowledge that I understand the following:

The applicant has not attended a past Breakthrough T1D Children's Congress as a Delegate.*

Only one parent / guardian may officially attend Breakthrough T1D 2027 Children's Congress, due to space and budgetary limitations.

All meals provided throughout Breakthrough T1D 2027 Children's Congress will be served buffet-style and prepared in the hotel's banquet kitchen. While reasonable accommodations will be made, there is no way to guarantee that the meals prepared will be free of foods that could have an adverse impact on those with severe allergies.*

We agree to complete all Delegate assignments, including, but not limited to, creating a Delegate video and scrapbook; and writing letters to Members of Congress, in adherence with all guidelines and deadlines provided by the Breakthrough T1D Advocacy staff in advance.*

We will participate in every event at Breakthrough T1D 2027 Children's Congress.*

There may be discussion of complications from diabetes during Breakthrough T1D 2027 Children's Congress.*

If selected and if we agree for my child to attend Breakthrough T1D 2027 Children's Congress, Advocacy activities will continue after the D.C. event concludes. These activities may include: local media coverage, speaking arrangements, Breakthrough T1D Advocacy calls to action, attending Breakthrough T1D 'Together We Can' (formerly 'Promise to Remember Me') and 'New Member Outreach Initiative' meetings, among others.*

If selected as a Delegate, I hereby grant permission to Breakthrough T1D to use my child’s name, image, likeness, the sound of their voice as recorded on audio or video tape and to grant nonrevocable, non-transferable, perpetual rights to their life story, experiences, incidents, events and personal history without any payment or any other consideration. I understand that my child’s image may be edited, copied, exhibited, published or distributed as part of a promotion, marketing campaign, presentation or any other way Breakthrough T1D considers necessary to advance its mission. I waive the right to inspect or approve the finished product in which my child’s likeness appears. Additionally, I waive any right to royalties or other compensation arising from or related to the use of my child’s image, recording or story. I also understand that this material may be used in diverse fundraising settings within an unrestricted geographic area. By initialing below, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via Direct Mail, the Internet or in the public Breakthrough T1D setting. There is no time limit on the validity of this release, nor is there any geographic limitation on where these materials may be distributed. This release applies to photographs and/or audio or video recordings collected as part of the sessions listed on this document only. By initialing this release freely and voluntarily, I acknowledge that I have completely read and fully understood the above release, and agree to be bound thereby. I hereby waive any and all claims, including copyrights or intellectual property rights claims, against any person or Breakthrough T1D utilizing this material for marketing and promotional purposes.*

View full Privacy Policy here.

We will abide by the rules, conventions and terms of the Breakthrough T1D 2027 Children's Congress.*

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Apply for Breakthrough T1D 2027 Children’s Congress

Child Information

Parent Information

Engagement

By signing the below, as the parent/guardian of the applicant submitting this application I acknowledge that I understand the following:

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