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REGISTRANT INFORMATION:

Please contact HayMatick at 778-882-4389 or info@haymatick.com for any questions regarding registration


(* = required field)

*
*First Name
 
*Last Name
*Address
 
*Institution/Hospital
or Company
*City
 
*State/Province
*Zip/Postal
 
*Country
*Telephone
 
*Email
  *Specialty
*Are you a Fellow/Resident/Trainee?    

ACCOMMODATION:
Fairmont Chateau Whistler, Whistler BC

The Canadian Breast Cancer Symposium has negotiated a discounted room rate of $244/night. Please book your hotel room before December 29 at the link below. Room rate or availability is not guaranteed after December 29, 2017. It is a very busy time in Whistler, please be advised rooms sell out very quickly.

To book your accommodation directly with Fairmont Chateau Whistler click here.

Comments / Questions
Please make your own airline and travel arrangements.

PLEASE RSVP:

*Will you be attending the Friday night Canadian Breast Cancer Symposium Welcome Reception at 6pm at the Fairmont Chateau?  

ADDITIONAL INFORMATION:

*If you have SPECIAL DIETARY NEEDS,
please indicate your requirements
 

The Canadian Breast Cancer Symposium shares a participant list with Silver to Platinum 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:

REGISTRATION FEES:

Registration fees collected by HayMatick on behalf of the Canadian Breast Cancer Symposium - REGISTRATION FEES (Canadian Dollars)

Early bird registration fee available before December 29, 2017: $250
Registration fee after December 29, 2017: $300
Allied health professionals, residents and fellows: $150

PAYMENT INFORMATION:


We are using SSL (Secured Socket Layer) encryption technology to protect your credit card information during transmission.
Credit Card
   
Credit Card Number
Expiry Date
CVD
(3-4 digit code)
Cardholder Name
Payment Amount $250

PLEASE MAKE CHEQUE PAYABLE TO "HayMatick Meetings & Events"
PAYMENT BY CHEQUE CAN BE MAILED IN ADVANCE TO:

HayMatick Meetings & Events
#202-5525 West Bouelvard
Vancouver, BC  V6M 3W6

Registration fee refunds, full or partial, will not be issued within 30 business days of conference.