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Course Registration Form

DISCLAIMER: Please note that the event is going to be photographed and pictures may be used for publication by the Department of Otolaryngology Head & Neck Surgery.  Please write in the comments section of your registration, if you disagree with having your/your family photos published or send me an email no later than March 1,2019.

 

Special Note: "The organizers of the meeting will be initiating a trial to increase participant involvement in the sessions. Once registered for the course, Participants can submit their own interesting case(s) relevant to the topic of the individual sessions described in the program. The Moderators will review these submissions and select some to be presented within the panel discussions, if possible. Please note that there is no guarantee that your case will be incorporated in the session. The cases would need to be submitted by February 15th, 2019 the latest in ordered to be considered for inclusion. Please send details of the case, as well as results of accompanying relevant investigations (e.g., scans, images, etc). It is important that it complies with patient confidentiality established by CMQ, http://www.cmq.org/publications-pdf/p-6-2015-01-07-en-code-de-deontologie-des-medecins.pdf?t=1542124658918"

 

Registration Fee*:

  • Early registration (before March 6, 2019) is $500 CDN or $425 US
  • Late or on-site registration is $550 CDN or $470 US

Registration for residents and fellows is free. (Medical students interested in attending must contact Maria Gobbo at maria.gobbo [at] mcgill.ca)

* It is important to note that the registration fee does not include dinner for your companion or children. Saturday dinner tickets for your companion and children may be purchased on site at the following costs:

Adult 18 yrs old and over - Price $85 CDN / $75 US

Children 12 to 17 yrs old  - Price $60 CDN / $50 US

Children 6 to 11 yrs old - Price $30 CDN / $25 US

Young children 0 to 5 yrs old - free

Note:

  • WE ACCEPT CREDIT CARDS FOR COURSE REGISTRATION.
  • YOUR REGISTRATION WILL BE CONFIRMED UPON RECEIPT OF YOUR PAYMENT.
  • The registration fee includes a Saturday buffet dinner for the registrants.
  • Saturday buffet tickets for companions and family members may be purchased on site.
  • Registration fee does not include dinner for your companion.
  • Any requests for refund of registration cost must be received in writing prior to the start of the meeting and will be subject to a $50.00 administration fee.

 

PAYMENT METHOD

Payment by Credit Card:

Please fill out the registration form below and call 514-843-2820 with your credit card in hand, Mondays to Fridays from 8:00 am to 3:00 pm to make the payment.

Payment by Cheque:

Please fill out the registration form below and send by mail along with cheque payable to "MUHC Account #65689" to the following address:

Maria Gobbo, Registration Coordinator

Department of Otolaryngology - Head and Neck Surgery

McGill University Health Centre - Glen Site

1001 Decarie Blvd., Room D05.5711

Montreal, Quebec (Canada)

H4A 3J1