Registration Form

A. Identification


Medical Speciality:
Professional License Number

B. Special Needs

C. Workshop Preferences

ANNUAL SPECIALTY DAY: Baby Basics: Infant Health from Head to Toe
February 12, 2020
SESSIONS I to III
Please rank the workshops in order of preference (1 to 6). You will be assigned to 3 workshops on a first-come, first-reserved basis.
Choice: Workshop Name:
Neonatal Resuscitation Program (NRP) Refresher
Head to Toe - What Not to Miss on the Newborn Exam
Baby Formulas - Options and Evidence
Deliver with Care - Review of Newborn Birth Trauma
Approach to the Blue Baby
Neonatal Rash Review
PRACTICAL PROBLEMS IN PEDIATRICS
February 13, 2020
Please rank the workshops in order of preference (1 to 6). You will be assigned to 3 workshops on a first-come, first-reserved basis.
Choice: Workshop Name:
X-ray Rounds
The Challenges of Adolescent ADHD
Scrapes and Breaks - Managing Minor Trauma in the Office
Go with the Flow - Menorrhagia Management
Dealing with a Picky Eater
How Is Climate Change Affecting the Health of Our Children?

D. Registration Fees

For Physicians
Baby Basics: Infant Health from Head to Toe
Feb. 12, 2020
Practical Problems in Pediatrics
Feb. 13-14, 2020
Both Courses
Feb. 12-14, 2020
Early Bird:
Before
Dec. 16, 2019
Regular:
After
Dec. 16, 2019

For Nurses or Residents
Baby Basics: Infant Health from Head to Toe
Feb. 12, 2020
Practical Problems in Pediatrics
Feb. 13-14, 2020
Both Courses
Feb. 12-14, 2020
Early Bird:
Before
Dec. 16, 2019
Regular:
After
Dec. 16, 2019

For Invited Speakers
Click if you are an invited speaker          

On-site registration*
.................... Baby Basics: Infant Health from Head to Toe
Feb. 12, 2020
Practical Problems in Pediatrics
Feb. 13-14, 2020
Both Courses
Feb. 12-14, 2020
After Feb. 1, 2020

A one-day registration for the Practical Problems in Pediatrics Course is $410. After Feb 1, 2020 one-day registration is $435.00.

Early Bird is before December 16, 2019. After December 16, 2019, prices revert to Regular.

*After February 1, 2020, registration will be done on site. On-site registrants will be assigned workshops on the basis of availability.





E. Meet the Expert


I wish to attend the following Meet the Expert lunchtime session(s) (cost $45 per session; space is limited; first-come, first served):

Thursday,
Feb. 13, 2020
 ADHD/Psychiatry Closed   ... OR ...
 Gynecology

 Remove Choice
$

Friday,
Feb. 14, 2020
 Gastroenterology  ... OR ...
 Hematology

 Remove Choice
$
Meet the Expert Fees: $

Cancellation Policy

Full refunds, less an administrative fee of $50.00, will be made for written cancellations received by January 10, 2020. After January 10, 2020, only 50% will be refunded, and no refunds will be issued for cancellations received after February 1, 2020.


 I have read and acknowledge the cancellation policy.



F. Method of Payment

  Total Amount (Registration Fee + Meet the Expert): $

Online Credit Card Payment (VISA, Mastercard, Discover, American Express, Diners Club, Carte Blanche, JCB and Visa Debit)
Certified Cheque/Money Order/Bank Draft
(Please make payable in Canadian funds to "O'Donoughue & Associates Event Management Re : Pediatric Courses")
Credit Card Payment by Fax