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 1 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: anancoo-khan@xceptionaleventstt.net 2