Registration


Please complete this registration form

Start by selecting your ticket(s). * indicates a required field.

Ticket Type Price Spaces
Industry/private sector/private practice $850.00
University/hospital/government affiliation $660.00
General public/patient/parent $425.00
Not-for-profit/NGO $425.00
Research staff $425.00
Student/trainee $425.00
Additional gala banquet guest $160.00
Single day - to attend the daytime program of one conference day

* Single-day registration excludes evening activities (dinners). Specify your selected day in the registration form below.

$160.00

Opening reception (January 27)
Gala dinner and awards (January 29)
CHILD database workshop (Jan 30)
None

Yes, include me in the online registrants list
No, do not include me in the online registrants list

Yes, I have allergies or special needs
No allergies or special needs

I am anaphylactic
I carry an epinephrine autoinjector

Allergies (specify below)
Vegetarian
Other needs (specify below)

Need a roommate

I agree to the following cancellation policy: All payments are non-refundable unless a cancellation request is received in writing 30 working days prior to the start of the event (i.e., by 11 December 2018). An administrative fee of $75 will apply to all cancellations.


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