2025 Liver Conference Sponsor Registration Form

CONTACT INFORMATION

Title:
First Name:
Last Name:
Company Name:
Address Line 1:
Address Line 2:
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:
Business Phone: (Please include area code)
Fax: (Please include area code)
Email:
Do you have dietary concerns?:	Yes  No
Concern:

Events

Welcome Dinner (Friday)	Yes  No
Short Snapper Session (Saturday)	Yes  No
Breakfast (Saturday)	Yes  No
Scientific Sessions (Saturday)	Yes  No
President's Gathering (Saturday)	Yes  No
Breakfast (Sunday)	Yes  No
Scientific Sessions (Sunday)	Yes  No

Hotel Reservations

Note: Your room will be reserved, but you will be billed by the Hotel upon checkout.

We will require hotel accommodation	Yes  No
Room Type	SOLD OUT! Traditional with 2 Queen Beds: $309.00 p/n Traditional with King: $309.00 p/n (2 rooms remaining)  Deluxe King with Fireplace: $309.00 p/n (23 rooms remaining)  SOLD OUT! Deluxe King with Fireplace with water view: $309.00 p/n SOLD OUT! Premium with 2 Queens, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Premium with King, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Premium with King, Fireplace and Jetted Tub with water view: $309.00 p/n SOLD OUT! Dock Master Premium with Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Dock Master Suite with Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Junior Suite with King, Fireplace and Jetted Tub with water view: $309.00 p/n SOLD OUT! Suite with King, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Suite with King, Fireplace and Jetted Tub with water view: $309.00 p/n
Number of nights	1 2 Other
Arrival Date	Time:
How many people are in your party?	1 2 Other
Do you require a 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! Traditional with 2 Queen Beds: $309.00 p/n Traditional with King: $309.00 p/n (2 rooms remaining)  Deluxe King with Fireplace: $309.00 p/n (23 rooms remaining)  SOLD OUT! Deluxe King with Fireplace with water view: $309.00 p/n SOLD OUT! Premium with 2 Queens, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Premium with King, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Premium with King, Fireplace and Jetted Tub with water view: $309.00 p/n SOLD OUT! Dock Master Premium with Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Dock Master Suite with Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Junior Suite with King, Fireplace and Jetted Tub with water view: $309.00 p/n SOLD OUT! Suite with King, Fireplace and Jetted Tub: $309.00 p/n SOLD OUT! Suite with King, Fireplace and Jetted Tub with water view: $309.00 p/n
Number of nights	1 2 Other
Arrival Date	Time:

Policies

Photographs

The OAG, from time to time, will take photos of Conference delegates for our website, twitter page, blog or future promotional material. If you do not wish to have your photograph published, please check the box below

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.