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Register

Please contact HayMatick at 604-355-0425 or info@haymatick.com for any questions regarding registration.

REGISTRANT INFORMATION:
(* = required field)

*
*First Name
 
*Last Name
*Institution/Hospital/
Clinic
 
*Address
*City
 
*State/Province
*Zip/Postal
 
*Country
*Telephone
 
*Email
*Specialty
Are you a Fellow, Resident, Student or Postdoctoral Student?    
Are you an Allied Health Professional? (nurse or pharmacists)    

We would like to share a list of CAMP PODS participants with our sponsors that includes the participant's name, specialty and city. Please check the box below if you DO NOT wish to have your information included on this participant list:

PRESENTATIONS:
*Please choose which presentation(s) you would like to register for: