* Required Fields
Full Name : *
Address 1 : *
Address 2 :
Town/City : *
Province : *
Postcode : *
Phone : *
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Clinic Name (If applicable):
AGM Event Fee: FREEContinuing Education Event Fee: $100
Includes:
CE Hours
Free breakfast and lunch for each event day
Free Parking
Payments can be made at the events registration table
