ATTENDEE INFORMATION
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| Last Name: * |
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| Name Preferred on Badge: * |
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| CBDC Title: * |
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| Other Title: |
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| Corporation: * |
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| Address: * |
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| Town: * |
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| Province: * |
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| Postal/ZIP Code: * |
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| Telephone: * |
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| Fax: |
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| Email: * |
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| In case of emergency: |
| Contact: * |
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| Phone #: * |
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MEAL INFORMATION |
Wednesday, May 30th
Breakfast 7:00 am - 8:30 am
- Meal includes a buffet breakfast
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| DIETARY / PHYSICAL NEEDS |
| Please indicate if you have any dietary needs that we can accommodate to make the event more comfortable for you? |
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Diabetic Meals
Vegetarian Meals
Vegan Meals
Other Dietary Needs
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| Please Specify: |
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| Please indicate if you have any physical needs that we can accommodate to make the event more comfortable for you? |
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Handicap Accessibility
Other Physical Needs
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| Please Specify: |
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PARTNER / GUEST INFORMATION |
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REGISTRATION PACKAGE / FEE
The registration package/fee includes Wednesday morning buffet breakfast and nutrition break. |
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GUEST OPTIONS |
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FEE / PAYMENT |
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CANCELLATION POLICY: All cancellations are subject to a $25.00 fee. Cancellations made after Friday, May 11th, 2012 are non-refundable. To make changes or for more information, please contact us at:
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