Online Registration

12-13 September, 2008
Winnipeg Manitoba CANADA

Online Registration is now closed. However, as long as there is space, you can register at the door, at 7:30am on Friday, 12 September 2008, for $170 CAD per person. No new attendees will be accepted after Friday. As of now, Wednesday, 10 September 2008, there still is some space.

Registration by Mail Click here to download the print-friendly pdf version of the brochure, 2 pages, 305 Kb
  • You may print out the brochure, which contains a registration form. Then fill it out and mail to the address below, with your payment, either by check or credit card.

  • Or, if you aren't able to print out the brochure, you may simply print this page, and fill it out and mail it in with your payment. Please make checks out to Brain Science Conference, and mail to:

Wellspring Healthcare
647 Broadway Avenue
Winnipeg Manitoba CANADA R3C 0X2


Registration Form

 

____________________________________________________________________

First name, Last name

____________________________________________________________________

Address

____________________________________________________________________

Address

____________________________________________________________________

City/State/Postal Code

____________________________________________________________________

Country

____________________________________________________________________

Email / Phone #

____________________________________________________________________

Organization, if registering a group of four or more

For Group Registrations: Please enclose a registration form, or a separate sheet of paper with the names, addresses, emails, and phone numbers of all the people you are registering. To receive the group discount, all 4 or more of the members of the group must be registered together.

PAYMENT (All prices are listed in CANADIAN dollars):

Individual Registration $170 after 18th July =_______________

Group (4 or more) after 18th July $160 x _________(# of persons) = ____________

University Student (taking 3 or more courses) $120 (any time) = ____________

Please make checks out to Brain Science Conference, or fill in credit card information below, and mail to the address above.


Credit Card type:__________________ . . Card Expiration Date:_______________

Card Number:|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

Signature:______________________________________________Date:__________

Printed name:_________________________________________________________

Address of credit card holder, as shown on credit card statement:

_____________________________________________________________________

_____________________________________________________________________

Thanks! We look forward to seeing you!

Cancellation Policy: Cancellations made by 4 August 2008, will be refunded less a $25 USD processing fee per transaction. If the cancellation causes a group registration to fall below the minimum number of four persons, then the remaining members of the group will be charged the individual registration rate, and the amount to be refunded will be debited that difference in price, as well as the processing fee. No refunds for cancelled registrations will be made after 4 August 2008. Please note, however, that paid registrations may be transferred to another person. Please notify us if you find you must cancel. If you find someone else to whom to transfer your registered spot, we need to know that person's name and contact information.

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