REGISTRATION FORM
Registration fees
Regular registration: $120
HRH staff: $75
please put "HRH" and indicate department in agency field to receive HRH staff discount
Reduced rate for Organizations - groups of 3 or more: $95
if you are non-HRH staff and are attending together with 2 other colleagues or more, please ensure all colleagues complete the "Agency" field with the same organization name to ensure the reduced $95 fee can be processed.
You may pay by credit card by completing the appropriate fields on this form, or by cheque made out to Humber River Hospital and sent to:
Mary Pistilli
3rd Floor Administration
Humber River Hospital
1235 Wilson Avenue
Toronto, ON M3M0B2
(if paying by cheque please send
by October 21)
* indicates required fields when completing form