Register

PLEASE NOTE: ONLY INDUSTRY THAT ARE SPONSORING THE CONFERENCE MAY REGISTER.
CONFERENCE IS NOT OPEN TO NON SPONSORING INDUSTRY

REGISTRANT INFORMATION:

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

(* = required field)

* Dr. Mr. Mrs. Ms.

*First Name

*Last Name

*Institution/Hospital
or Company

*Address

*City

*State/Province

*Zip/Postal

*Country

*Telephone

*Email

*Specialty

*Are you a fellow or resident?

YES NO

*Are you an allied health professional (nurse, pharmacist)?

YES NO

ACCOMMODATION:
Fairmont Banff Springs Hotel, Alberta

CCOLD has negotiated a discounted room rate of - $283/night +tax. Please book your room at the link below while rooms are still available. The conference rate is available until rooms sell out or February 22nd.

To book your accommodation directly with Fairmont Banff Spring Hotel click here

PLEASE RSVP:

*Will you attend the Friday evening dinner at the Fairmont Banff Spring Hotel?

YES NO

*Will you attend the Saturday evening dinner at the Fairmont Banff Spring Hotel?

YES NO

ADDITIONAL INFORMATION:

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

CCOLD shares a participant list with Silver to Platinum sponsors that includes the participant's name, email, specialty and city. Please check the box below if you DO NOT wish to have your information included on this participant list:

I DO NOT CONSENT to being on the participant list

Comments / Questions

REGISTRATION FEES: (Canadian Dollars)

Registration fees collected by HayMatick on behalf of CCOLD.

Will you be attending the Live meeting or Virtual meeting (Same Fee)?

Live Virtual

Early Bird Registration until February 24th, 2023
General Registration fee is $350. Allied Health Care Professionals, Fellows/Residents is $150.

After February 24th, 2023
General Registration fee is $450. Allied Health Care Professionals, Fellows/Residents is $200.

These fees cover the conference registration, Friday evening reception/dinner, Saturday reception/dinner for the delegates attending the conference.

PAYMENT INFORMATION:

Payment Amount

PAYMENT BY Credit Card (VISA, MasterCard or American Express):
We are using SSL (Secured Socket Layer) encryption technology to protect your credit card information during transmission.

Credit Card	VISA MasterCard American Express
Credit Card Number
Expiry Date
CVD (3-4 digit code)
Cardholder Name

PAYMENT BY CHEQUE:

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

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

Registration fee refunds, full or partial, will not be issued within 14 business days of conference.