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FRANÇAIS

2010 CONFERENCE REGISTRATION

Note: Please don't register online if you are a speaker at the 2010 NICC or if you are a member of the NICC 2010 Advisory Committee. Instead, please contact laura.viau@msaresearch.com.

Delegate Conference FeesEarly bird pricing
(pay by May 31, 2010)		After June 1, 2010
Individual DelegatesC$1,195 ea.C$1,395 ea.
Three or more DelegatesC$995 ea.C$1,195 ea.

Cancellation Policy: Cancellation fee of $150 + GST/HST per registrant applies, no refunds after August 30, 2010. Substitutions allowed at any time.

If registering three or more delegates please do not use this form. Rather, please either use the pdf registration form or contact Laura Viau at laura.viau@msaresearch.com or 416-368-0777 x 5 to make arrangements.

Fields with an asterisk (*) are required.
DELEGATE INFORMATION
* Name (First): 
* Name (Last): 
Name as you want it to appear on badge (if different): 
Title: 
* Organization: 
* Address Line1: 
Address Line2: 
* City: 
* Province/State: 
* Country: 
* Postal Code: 
* Email address: 
* Phone: 
Fax: 
Coupon Code (Optional): 
CONCURRENT SESSION OPTIONS
For complete conference agenda details, please click here.

Please select ONE of the following two options for the Tuesday morning concurrent business session:
  Managing Through a Pandemic
  Auto Reforms
SOCIAL GUEST REGISTRATION
Will you be accompanied by a social guest?
 Yes       No
Social Guest, name: 
Social Guest, badge name (if different): 
Click here for a complete description of the NICC Spousal Program
Please select one of the following guest/spousal program options
A. Conference Fee Only
(includes all conference meals and cocktail receptions)		 $199
B. Conference Fee plus Sept 19 Bain Scandinave Spa: Access to Scandinavian Baths + 60 minute massage + Brunch $379
C. Conference Fee plus Sept 20 Spousal Program: Flavours and Aromas of Old Montréal Walking Tour + Lunch $269
D. Conference Fee plus Sept 19 Bain Scandinave Spa plus Sept 20 Spousal Program $449
How many will be attending the Gala Dinner held on Monday, September 20, 2010?
 1       2       Sorry, cannot attend
Please advise if you or your guest have specific dietary restrictions
Please advise if you or your guest are physically challenged and require special services
Golf tournament at Club de Golf de l’île de Montréal, Sunday Sept.19

For details on NICC's golf tournament, please click here.

Tournament Fee: C$100 ea.
Includes: Green fees, power cart, boxed lunch, two beverages and taxes.
Club Rental Fee: $50/person (MUST be reserved in advance).
 Yes, I would like to register for the AON-BENFIELD/NICC golf tournament on September 19, 2010
 I would like to register for the Bain Scandinave Spa package instead of the golf tournament for $180
 None
I require rental clubs (MUST BE RESERVED IN ADVANCE):    Right Handed       Left Handed       No
 Yes, I would like to register my social Social Guest/Spouse for the golf tournament
My social guest requires rental clubs (MUST BE RESERVED IN ADVANCE):    Right Handed       Left Handed       No
Complete the foursome list below, if this has already been arranged.
If entering as a single and prefer a foursome to be arranged for you please CHECK THIS BOX:  

Other Players in Foursome (each player must be registered for the NICC and for the tournament):
1: Name:  Organization: 
2: Name:  Organization: 
3: Name:  Organization: 

Notes:
NICC will make best efforts to accommodate foursome requests.
If you are planning on registering others in addition to yourself and your social guest/spouse for golf, please do not use this form. Rather, contact Laura Viau at laura.viau@msaresearch.com or 416-368-0777 x 5 to make arrangements.
Note: Metal spikes are not permitted.
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