Breakout Session Submission Form - The Samaritan Summit

Clearwater Beach, Florida

November 2-5, 2026

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We are looking for breakout session speakers with a passion to support, encourage, and train pregnancy center staff and volunteers with the tools they need to reach abortion-determined women.

Breakout Session Title & Description

The information you provide will help us determine how well your proposed breakout session topic fits with the goals of the Samaritan Summit. Breakout sessions will be one hour and fifteen minutes in length; please develop teaching content accordingly. If your breakout session is pre-approved, please fill in your responses according to the pre-approved subject matter. If you would like to suggest an additional breakout session, please fill out a second submission form.

Through this submission, you are in agreement that you will not promote an initiative, ministry or organization outside of the Samaritan Summit.

Suggested Breakout Session Title: (Please limit to 10 words or less.)(Required)

Please note that breakout session titles and descriptions are subject to change for marketing purposes. A Choose Life Marketing or SperaVita staff member may be in touch with you if any adjustments need to be made.

Breakout Session Description: (Describe the topic and objectives of the Breakout session in four sentences or less.)(Required)

Breakout Session Takeaways: (Please describe the session takeaways or handouts that will be provided to attendees.)(Required)

What is the most valuable offering your Breakout session will provide to attendees?(Required)

Is this Breakout Session Pre-Approved: (Were you asked to host this breakout session topic?)(Required)

Yes

Breakout Session Attendees

Who would benefit most from the level of material you will be teaching on?(Required)

Basic (new to the subject matter presented)

Intermediate (has previous knowledge, but interested in learning more)

Advanced (has extensive knowledge or experience)

Breakout sessions should be tailored to Pregnancy Resource Centers and Pregnancy Medical Clinics, their Board Members, staff, and volunteers. Who would benefit most from the subject matter presented in your breakout session?(Required)

Board Development/Training

Executive Leadership Development/Training

Staff Development/Training

Fundraising/Development

Marketing for Donors

Marketing for Clients

Pregnancy Center Client Services/Client Care

Pregnancy Center Medical Services/Training

HIPAA Compliance

Abortion Trends/Data

Public Relations

Other

Breakout Session Presenter Information

Name(Required)

First Last

Credentials

Organization(Required)

Email(Required)

Phone (primary contact number)(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Presenter Photo(Required)

Accepted file types: jpg, jpeg, png, gif.

Presenter Biography(Required)

Are there additional people presenting your Breakout?(Required)

Additional Presenter #1

Name(Required)

First Last

Credentials

Organization(Required)

Email(Required)

Phone (primary contact number)(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Presenter Photo(Required)

Accepted file types: jpg, jpeg, png, gif.

Presenter Biography(Required)

Additional Presenter #2

Name(Required)

First Last

Credentials

Organization(Required)

Email(Required)

Phone (primary contact number)(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Presenter Photo(Required)

Accepted file types: jpg, jpeg, png, gif.

Presenter Biography(Required)

Additional Presenter #3

Name(Required)

First Last

Credentials

Organization(Required)

Email(Required)

Phone (primary contact number)(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Presenter Photo(Required)

Accepted file types: jpg, jpeg, png, gif.

Presenter Biography(Required)

Breakout Session Audio/Visual Needs

Will you be using a PowerPoint in your presentation?(Required)

Yes

Will you be using video that requires sound in your presentation?(Required)

Yes

Will you need a microphone for your presentation?(Required)

Yes

Presenters are required to bring their own laptop. Do you have a laptop for your presentation?(Required)

Yes

Breakout Session Presenter Agreement

By offering a breakout session for the Samaritan Summit, you agree to the following terms and conditions:

Every breakout session submission will be reviewed and considered, but not every submission will be selected for the Samaritan Summit conference.
Submissions will be evaluated according to the main purpose and focus of the Samaritan Summit conference and how well the title, description, and breakout session takeaways connect to the goals of the conference.
Submissions are due by January 16, 2026. If your submission is selected, you will be notified at the contact information you provided.
The Samaritan Summit has the freedom to edit breakout session titles and descriptions for the benefit of marketing materials and publications.
You agree to uphold the mission and vision of the Samaritan Summit conference and you will not promote your own organization or ministry and its programs.
The Samaritan Summit does not compensate breakout session presenters.
If your breakout session is selected, you will be provided with a registration code that offers one 50% conference registration discount, which includes meals (if you would like to attend other breakout sessions at the Samaritan Summit conference). General sessions may be attended without a conference registration ticket.
The Samaritan Summit is an in-person conference. Breakout session speakers will present their sessions in-person at the 2026 Samaritan Summit in Clearwater Beach, FL.
Presenters will cover their own expenses, including but not limited to conference registration fees and meals (one 50% discount provided), travel and lodging.
Presenters will be provided with audio/visual equipment, including a projector, screen, and microphone as needed. Presenters must provide their own laptops.
You agree to allow The Samaritan Summit to record and/or photograph your presentation and utilize the material for promotional purposes. Not every breakout session will be recorded.
Presenters will be required to provide their own handouts during their breakout session. The Samaritan Summit is not responsible for printing breakout session materials.
Presenters may promote their breakout sessions online or in print for marketing purposes.
If you need to cancel your registration, you will receive a 50% refund if canceled prior to July 31, 2026. Registrations cancelled after July 31, 2026 are not eligible for a refund. In the event of family emergency, natural disasters, or events beyond the control of the Samaritan Summit, conference registration fees will not be refunded, but will be credited toward next year’s conference.

I agree to the terms and conditions listed above.(Required)

Yes

By signing below, I confirm that I agree to the terms and conditions listed above.(Required)

First Last

Date(Required)

MM slash DD slash YYYY