Registration Sample

This registration form was used in March, 2011 for a webcast by The Arthritis Society to educate and inform about the topic of juvenile arthritis.

A panel of experts and a young person living with juvenile arthritis will share information and take questions. Topics include medications, the psychology of transitioning into adulthood and community supports for patients and their families.
Local Time: 11 a.m.
Location: Alberta Children’s Hospital, Conference Room # 14, 2888 Shaganappi Trail North West, Calgary, Alberta

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* Fields with an asterisk are mandatory. Those without an asterisk are optional.

Please check one or the other I plan to attend in person I plan to log into the webcast
NOTE: If you're not sure that you will be able to come in person, be sure to provide an email address below which will give you the option of logging into the webcast.
* Name:
Email (Mandatory for online, encouraged for in-person):
* Phone Number:
Address:
* Postal Code:
How did you find out about this event?
IMPORTANT
All personal information disclosed in this form is treated as confidential and will not be shared with any third party. In addition to using this information to fulfill any requests you've made of us, we will use it to tell you about our programs and services, and to ask for your financial support.
Please check this box if you prefer NOT to receive any additional communications. The information you provided to register for this event will only be used for that purpose and will not be retained.

Need help with this form? Contact us at: support@webcastcanada.ca.

Registration Sample

This registration form was used in March, 2011 for a webcast by The Arthritis Society to educate and inform about the topic of juvenile arthritis.

Complete this form

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