Delegate Registration

CUISA 2019 Conference

Fairmont Chateau Whistler

June 4-6, 2019

Conference Registration

* Required fields

First Name*
Last Name*
Company*
Address*
City*
P/Code*
Telephone*
Fax
Email*

FEES

1 Full or Partial Conference Package (not including Gala Banquet) $

(#) Additional Staff or Spouse @ $250/person $


(#) Conference Activity: Axe Throwing June 4 (space is limited ) $55/person $

(#) Gala Banquet Dinner (June 5th) @ $75/person $
Please list any food allergies for attending guests
  TOTAL CHEQUE ATTACHED (payable to CUISA)

Mail to: CUISA, #904 – 1641 Lonsdale Ave, North Vancouver BC V7M2J5
$

Please list the names of additional staff or spouse attending:

1
2
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5
Please answer the question below before submitting the form.


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