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National Conference General Registration Form

TOURETTE SYNDROME+

Edmonton, Alberta
September 29th – October 1st 2016

PLEASE READ CAREFULLY

Registration deadline is SEPTEMBER 16th, 2016.
Please fill out a separate form for EACH Registrant.

Your registration includes:
• All forum materials, morning and afternoon breaks, and onsite lunch & refreshments.
• Registration will begin at 7:30 am with the program beginning at 9:00 am.

Our Cancellation Policy:
• A $50 administration fee will apply to cancellations from August 19th to September 9th.
• No refunds issued after September 9th, 2016.

 


    BASIC INFO

    First Name

    Last Name

    Address

    City

    Province

    Postal Code

    Telephone (required)

    Email (required)

    Special Dietary Needs (no preferences please)

    I will attend the Opening Reception on Thurs. Sep. 29thI will attend the Saturday evening banquet on Oct. 1stI will attend a Meet & Greet group on Thurs. Sep. 29th for:

    METHOD OF PAYMENT

    Please charge to my:
    VisaMasterCardAmex

    Credit Card Number

    Expiry Date

    3 Digit Security Code

    Cardholder’s Name


    FULL CONFERENCE (includes Saturday banquet)

    Early Bird Rate (until September 1st, 2016):
    TC Member $320 Non-Member $375

    Regular Rate (after September 1st, 2016):
    TC Member $350 Non-Member $400


    ONE DAY RATE (includes breaks & lunch)

    Please check one:
    Friday, September 30thSaturday, October 1st

    Regular Rate (September 5th to October 7th):
    TC Member $165 Non-Member $200

    Additional Adult/Youth Banquet Ticket $75

    Child Banquet Ticket $30


    FULL FAMILY PACKAGE (includes Saturday banquet)

    Regular Rate - Save $230 (until September 16th):
    TC Members Only $950


    SUBTOTAL CONFERENCE FEES

    SUBTOTAL CHILD FEES

    SUBTOTAL YOUTH FEES

    TOTAL PAYMENT