AGM Delegate Registration (Invoice MHA) 2023

Association / Team / League name

If "Other", please specify:

Association / League Contact Name*

MHA / Team Position*

If "Other", please specify:

Phone Number*

Email*

Street Address*

City*

Province*

Postal Code*

Registration Fee: $100.00 + tax per delegate Spousal Banquet Ticket Fee: $100.00 + tax per spouse The following refund policy applies to cancellations: 50% refund up to 15 days prior to the start of the Annual Congress. NO REFUND within 14 days of the start of the Annual Congress for any reason

Delegate 1 - First Name*

Delegate 1 - Last Name*

Delegate 1 - Email*

Confirm Delegate 1 registration:*

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 2 - First Name

Delegate 2 - Last Name

Delegate 2 - Email

Confirm Delegate 2 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 3 - First Name

Delegate 3 - Last Name

Delegate 3 - Email

Confirm Delegate 3 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 4 - First Name

Delegate 4 - Last Name

Delegate 4 - Email

Confirm Delegate 4 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 5 - First Name

Delegate 5 - Last Name

Delegate 5 - Email

Confirm Delegate 5 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 6 - First Name

Delegate 6 - Last Name

Delegate 6 - Email

Confirm Delegate 6 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 7 - First Name

Delegate 7 - Last Name

Delegate 7 - Email

Confirm Delegate 7 registration:

Register

Spouse Ticket required?

Yes

Add another delegate?

Yes

Delegate 8 - First Name

Delegate 8 - Last Name

Delegate 8 - Email

Confirm Delegate 8 registration:

Register

Spouse Ticket required?

Yes

Do you wish to pay by*

E-Transfer (send to accounting@bchockey.net)Invoice MHA