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Down Syndrome Family Network World Down Syndrome 2014 Conference
“Health and Well Being: Access and Equality for all”
Registration Form
Full Name
Telephone
Address
Email Address
Organisation
Occupation
Names of adults
______________________________________________________________________________
Total Number of persons
Number of children and their age’s _____________________________________
Persons with Down Syndrome FREE
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Meals – Light lunch and snacks
Please note the following: - Lunch will only be provided for pre registered paid
attendees
Vegetarian no. of people _______________
Non Vegetarian no. of people ____________
REGISTRATION FEES (Includes light lunch and snacks)
DETAILS OF FEES
Members
Non-Members
Registration start time 7:00 am
$150.00
$250.00
End Time: 9:00 am
APPROVED METHODS OF PAYMENT
Please check appropriate box:
Deposit into RBC bank Account#
Cash
Cheque (CERTIFIED)
Bank deposit slips
Please note that the deposit slips can either be dropped into the office between the hours
of 10 and 4pm Monday to Friday or you can call the office and give them the number and
walk with the slip on the day. The deadline for registration is Wednesday 19th March
2014.
Registration Disclaimer
I understand the information on this form will be used for the purpose of processing my
registration, conference payment, and generating statistical information related to this
conference.
I understand
Please bring in, e-mail or fax completed registration form and payment
information/slips to:
Phone (868)663-0865
Fax: (868)663-6060
Email: [email protected]
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