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Edmonton Twin and Triplet Club

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Early Bird Registration Deadline: July 31, 2010 Extended

Payment is required in advance.

Early Bird date of July 31st Extended—Final date of August 20th 31st, 2010.

Registration will take place on Thursday (6:30—8:30pm), Friday (7:30—8:30am) and Saturday (7:30—8:30am) in the third floor foyer of the Fantasyland Hotel at West Edmonton Mall. The Conference begins at 9:00am on Friday morning. One day registration available.

Fill out the registration form below:

Please note: There is no online payment set up for the 2010 National Conference & MBC Annual General Meeting.

Download a PDF of the Registration Form

E-mail Address: *
First and Last Name: *
Address: *
City: *
Province: *
 Postal Code: *
Telephone (with area code): *
Are you a member of MBC? *
Yes No

If yes, please state your affiliation - Chapter/Affiliation:

Position held (if applicable):

Type of Multiples: *
Twins
Triplets
Quadruplets
Quintuplets

Age and Sex of Multiples:
Age and Sex of other children:
Have you suffered a loss?:
Yes No
Is your spouse attending the conference?:
Yes No
If so, would he like to attend an event tailored for fathers?:
Yes No
Are you a first-time attendee of an MBC Conference/Retreat?:
Yes No

Delegate Registration Fee: *

Deadline is August 31, 2010
*Note: A $25 cancellation fee will be charged if cancelled after Aug. 20/10 The Conference Fee covers attendance at five full group keynote sessions, choice of three workshops, three hot breakfasts, two lunches, four health breaks, Jubilations Dinner Theatre, Annual Banquet and Awards, Hospitality Suite, resource center, conference booklet and delegate bag.

One Full Day Only: This fee includes breakfast, 2 full group keynote sessions, two workshops, two health breaks, and lunch. (Jubilations or Sat. banquet not included).

Attending for only one full day?

Select:

Select Workshops:

Friday Morning
(September 24)

 1st
Choice:		 2nd
Choice:
Workshop #1 - Dr. Fiona Bamforth 
Workshop #2 - Patricia Kehoe
Workshop #3 - Dr. Karyn Gordon



Friday Afternoon
(September 24)
 1st
Choice:		 2nd
Choice:
Workshop #4 - Mardi Bernard
Workshop #5 - Patricia Kehoe
Workshop #6 - Dr. David Roseman



Saturday Morning
(September 25)		 1st
Choice:		 2nd
Choice:
Workshop #7 - Chapter Exchange #1
Workshop #8 - Chapter Exchange #2
Workshop #9 - Board Development Program



Please indicate any special dietary needs:
Do you have any other Special Requirements?
(You will be contacted later to discuss)
Yes No

Additional Tickets:
For additional tickets to attend the Friday Night Jubilations Dinner Theatre or Saturday Banquet and Awards Dinner. This fee does not allow that person to enter the workshops.

Friday Night: Jubilations Dinner Theatre ($60 each)
Name(s) of Additional People:

Saturday Night: Banquet and Awards Dinner ($55 each)
Name(s) of Additional People:

Remember to mail your Registration Fee and Additional Tickets Fee payment to:
Edmonton Twin & Triplet Club
P.O Box 809
Edmonton, AB T5J 2L8

 
* Required

 

 

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