NWO Palliative Care Conference Booster - Cheque | Centre for Education and Research on Aging & Health

NWO Palliative Care Conference Booster 2024

PLEASE NOTE: THIS FORM IS FOR CHEQUE PAYMENTS AND ONLY TO BE USED IF YOU ARE GIVEN THIS LINK DIRECTLY!

Date:
October 2, 2024
8:30am - 4:30pm (ET)

Location:
In-Person: Thunder Bay, Ontario - Superior Inn Hotel & Conference Centre
Virtual: via Zoom Platform

In-Person Conference Registration Includes:

All Keynote Presentations (4)
Nutrition Breaks (2)
Breakfast
Lunch
Networking Opportunities with Delegates, Presenters, and Booth Displayers
Conference Bag & Swag
Certificate of Completion

Virtual Conference Registration Includes:

All Keynote Presentations (4)
Networking Opportunities
Certificate of Completion

Please note: If you are registering multiple delegates, each one will require a separate registration with a unique email address.

	IN-PERSON REGISTRATION	VIRTUAL REGISTRATION
Full Delegate	$200	$165
Full-Time Student*	$100	$100
Hospice Volunteer**	$100	$100

Registration Fees include HST.
*Full-time Students must provide proof of full-time enrolment to receive the student rate.
** Hospice volunteers must register through their volunteer organization to receive the volunteer rate.

Registration Fee *

In-Person - Full Delegate [$200.00]

In-Person - Full-Time Student [$100.00]

In-Person - Hospice Volunteer [$100.00]

Virtual - Full Delegate [$165.00]

Virtual - Full-Time Student [$100.00]

Virtual - Hospice Volunteer [$100.00]

First Name *

Last Name *

Email Address *

Phone *

Address *

Country *

Address 1 *

Address 2

City *

Province *

Postal code *

Role/Discipline *

Organization *

Food Allergies (if any)

Emergency Contact

Emergency Contact Full Name *

Emergency Contact Phone *

Acceptance

Language Presentation *

I acknowledge that I understand the language presentation format. There will be no interpretation provided at the conference. All main sessions (e.g opening and closing ceremonies, keynotes, and panels) will be presented in English. Presentations will be delivered in the language determined by the presenter. Program materials will identify the language of each session.

Media Usage *

I acknowledge that I have read and understood the photograph and video statement below. By registering for this conference, you acknowledge that photos and videos may be taken throughout the event. Photographs may be taken during this event, which may or may not include your recognizable image. Your attendance constitutes permission for the conference organizers to use these photos and videos for promotional purposes, including but not limited to website, social media, and marketing materials. If you do not wish to be photographed or filmed, please notify May Remenda at mkremend@lakeheadu.ca

You will receive an email confirming your registration, but please note, your registration is NOT COMPLETE until we have received your cheque payment. If you do not receive an email within 3 days, please contact May Remenda at mkremend@lakeheadu.ca

Please make cheques payable to:
CERAH - Lakehead University
955 Oliver Road
Thunder Bay, ON, P7B5E1

Cancellation Policy:

If you must cancel your 2024 conference registration, CERAH must receive written notice of cancellation by email. Requests should be submitted to: mkremend@lakeheadu.ca

Cancellation requests received:

On or before September 18, 2024 – Full refund minus a $50 administration fee
Between September 19, 2024 - September 30, 2024 – 50% refund + $50 administration fee
On or after October 1, 2024 – No refund

Please note that there is no charge for transferring a registration to another person.