CONTACT INFORMATION

Title:
First name:
Last name:
Company Name:
Business Address:
Suite:
City:
Province/State:	Please select a province... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code/Zip Code:
Phone: (Please include area code)
Fax (Please include area code)
Email:
Twitter:
Facebook:
Instagram:
Do you have dietary concerns?:	Yes  No
Concern:

Events

Welcome Dinner (Friday)	Yes  No
Breakfast (Saturday)	Yes  No
Scientific Sessions (Saturday)	Yes  No
President's Party (Saturday)	Yes  No
Breakfast (Sunday)	Yes  No
Scientific Sessions (Sunday)	Yes  No

Hotel Reservations

Note: For our members, the OAG will cover the cost of a Deluxe Room for up to two nights of your accommodations. If you choose an alternate room option, we will apply the cost of a Deluxe room to your accommodation. Delegates are responsible for incidentials and room upgrade costs.

We will require hotel accommodation	Yes  No
Room Type	SOLD OUT! Deluxe Room: $379.00 p/n One Bedroom: $429.00 p/n (30 rooms remaining)  One Bedroom with Den: $479.00 p/n (1 room remaining)  Two Bedroom: $599.00 p/n (3 rooms remaining)
Number of nights	1 2 Other
Arrival Date	Time:
How many people are in your party?	1 2 Other
Do you require a child's crib?	Yes  No
Do you require an additional room? (At delegate’s expense.)	Yes  No
Do you require an interconnecting room?	Yes  No
Rates for Additional Room	SOLD OUT! Deluxe Room: $379.00 p/n One Bedroom: $429.00 p/n (30 rooms remaining)  One Bedroom with Den: $479.00 p/n (1 room remaining)  Two Bedroom: $599.00 p/n (3 rooms remaining)
Number of nights	1 2 Other
Arrival Date	Time:

Companions/Spouses/Guests/Young Adult (Ages 13-18)

Guest's Title
Guest's First Name
Guest's Last Name
Guest's Email (Required for Mobile App)
Additional Registrant is:	Companion/Spouse Guest Young Adult (Ages 13-18)
Specify Age:	13 14 15 16 17 18
Does your guest have dietary concerns?	Yes  No
Concern:
Welcome Dinner Only ($100.00)	Guest will attend
President's Party Only ($110.00)	Guest will attend
Entire Event ($325.00)	Guest will attend
Guest will attend the following events:	Welcome Dinner (Friday) Breakfast (Saturday) President's Party (Saturday) Breakfast (Sunday)

Add Another Guest

Children

Child's First Name
Child's Last Name
Age	4 - 12 ($225.00) 0 - 3 ($0.00)
Specify Age:
Does your child have dietary concerns?	Yes  No
Concern:
Entire Event	Child will attend
Child will attend the following events:	Welcome Dinner (Friday) Breakfast (Saturday) Breakfast (Sunday) Children’s Program (Saturday Evening) Ages 4 - 12

Add Another Child

Policies

Photographs

The OAG, from time to time, will take photos of Conference delegates for our website, twitter page, blog or future promotional material.

Yes, you may publish my photograph on the OAG website, twitter page or blog. No, Please do not publish my photograph on the OAG website, twitter page or blog.

Cancellation Policy & No Show Policy

OAG Privacy Policy

The OAG produces a Mobile App, which includes the following business information of registered GI delegates: full name, address, telephone, fax and email address. Conference sponsors may use this information to contact you. This information will not be used for any other purpose by the OAG.

Yes, you may publish my contact information No, please do not publish my contact information

Subtotal:
Tax (13% HST - HST # 858140973 RT0001):
Total Payable: