Registration 2015

Proudly Presents Nicole Wilde Seminar June 20 & 21, 2015 Registration Form Name ___________________________________________________ Mailing Address ___________________________________________ City _________________________ Province/State _______________ Postal Code/Zip Code _______________________________________ Phone _______________________ Cell ________________________ Email ____________________________________________________ Please include my email address on your list to notify of future seminars YES [ ] NO [ ] I am: a trainer [ ] involved in rescue [ ] dog care staff [ ] dog enthusiast [ ] other _____________________________________________________________ How did you hear about the seminar? __________________________________ I am a CPDT-­‐KA/KSA and require CEUs YES [ ] NO [ ] 11 CEUs available Certificate # _______________________ Registration Fees (Canadian Funds) Early Bird Fee* Before March 30, 2015 Regular Fee Deadline June 1, 2015 Sub-­‐total $ __________ Plus 5% tax $ __________ Total $ __________ $250.00 [ ] $275.00 [ ] *Early Birds will also be entered into a draw to win a copy of Nicole’s latest book “Hit by a Flying Wolf” 1 Payment Options VISA [ ] Mastercard [ ] E-­‐Transfer to nicole@dogspaw.ca [ ] Name as it appears on card __________________________________ Billing address for card ______________________________________ City ________________________ Province/State _________________ Postal Code/Zip Code ________________________________ Credit Card # _______________________________________________ Expiry Month _______________________ Year ___________________ SVC (security code) _______________________ Sending Your Registration Print/scan all 3 pages of the form and forward to: shelley@dogspaw.ca Mail to: OR Seminar at Dogspaw 12215 William Short Road Edmonton AB T5B 2B7 Details, Details Payment in full must be received before you are considered registered for the seminar. Confirmation emails will be sent out when payment has been received. Should you have any concerns regarding the sending of your credit card information via email, you may call Dogspaw directly to speak to our receptionist to exchange information. Call (780) 471 2275. Cancellations and requests for refunds must be made in writing. Cancellations made on or before April 30, 2015 will receive a full refund of paid fees minus a $50.00 cancellation fee. Cancellations received on or after May 1, 2015 will not be eligible for a refund. Name Changes to Registrations will be accepted up to and on June 1, 2015. Changes are final and cannot be altered. Requests must be made in writing. A $25.00 administration fee will be charged. 2 Weather and Seminar Location This seminar will be held in the Radisson Hotel and Conference Center’s Western Conference Ballroom, located in (east) Edmonton, Alberta, Canada. Please note that pets are not permitted in this hotel. Weather will only be a factor in case of traveling conditions that would prevent the seminar presenter from getting by air to Edmonton (severe hurricane, tornado, blizzard or other extreme weather). Otherwise, this seminar will take place regardless of weather. Refreshments Coffee, tea, bottled water and light snacks will be provided. Lunch is not included. The Radisson Hotel has a café, which features a buffet lunch or menu choices. Hotel Information The Radisson Hotel and Conference Center is located at 4520 76 Ave NW, Edmonton, near the Sherwood Park Freeway. Call directly to reserve a room: (780) 468 5400. Toll free: 800 333 3333. Online bookings may be made via website: http://www.radisson.com. Please make sure you are contacting the correct Radisson as there is more than one in Edmonton. The Radisson is setting aside a limited block of rooms at a rate of $129.00 plus taxes per room per night based on single or double occupancy. Please contact the Radisson directly, using the block code: 201506DOGS or the name Dogspaw Training Event. This rate cannot be booked via any third party or online booking agency and must be booked prior to the cutoff period on May 20, 2015. Questions may be directed to shelley@dogspaw.ca FOR OFFICE USE ONLY: Date received: __________________________ Processed by: ______________________ Payment received/cleared on: ______________________ for the sum of $ ___________ Emailed confirmation on: _____________________ by ___________________________ Notes: ___________________________________________________________________ _________________________________________________________________________ _______________________________________________________________________________________________________________________ 3