BC Cancer Summit November 16

BC Cancer Summit
November 16 - 18, 2023
Sheraton Wall Centre, Vancouver

ONLINE REGISTRATION FORM

I will be attending the Summit

Virtually/On-line

In-Person
In-Person attendance includes access to the virtual platform

Physicians	In-Person	Online	Non-Physicians	In-Person	Online
Early Bird Fee (on or before September 30, 3 conference days)	$149	$49	Early Bird Fee (on or before September 30, 3 conference days)	$99	$19
Regular Registration Fee (on and after October 1, 3 conference days)	$199	$59	Regular Registration Fee (on and after October 1, 3 conference days)	$149	$29
On-Site Fee	$250	$99	On-Site Fee	$250	$69
One-Day Fee	$149	$49	One-Day Fee	$99	$19
Other
Residents & Fellows	$50	$19	Awards Dinner (In Person event, cost per person)	$60
Student Fee (Allied health students, Medical, undergraduate students) Please note: additional information will be required when registering.	$0		Additional Exhibiting Pharmaceutical Attendees	$5000

General Information:

Privacy Notification – Personal, registration and payment information collected on this registration form, payment processor, Event platform application and quality survey is authorized, pursuant to Sections 26(c) (e) 27, 30.1 33.1. Personal registration and payment information used, accessed and disclosed by BC Cancer is subject to local data laws and protections (Canada/GDPR/USA) is authorized pursuant to Sections 32(a-c) 33, 33.1, 33.2 of the Freedom of Information and Protection of Privacy Act ("FIPPA"). BC Cancer will use your information to send you BC Cancer Summit registration information, payment processing and for quality improvement purposes. Your information will remain confidential, and will only be used or disclosed as authorized under FIPPA. Should you have any questions about the collection of information, please contact Dawn Lake, Corporate Director, Information Access and Privacy Services, 200-601 West Broadway, Vancouver, BC, V5Z 4C2, by email at Privacyandfoi@phsa.ca or by phone at 1-855-229-9800.

Your personal information will not be shared with any vendor, exhibitor or sponsor without your explicit consent.

The BC Cancer Summit will be utilizing an event platform, allowing attendees to access to options such as viewing schedules, maps, and responding to quality improvement surveys. Your contact information is required in order for the Summit organizer to grant access to the app with a password. Please provide your consent:

I consent to having my contact information provided to the Summit organizers and event platform support staff for the purpose of using the platform at the BC Cancer Summit, November 16-18, 2023

Yes No

Vendor, Exhibitors and/or Sponsors:

I consent to having my contact information provided to BC Cancer Summit vendors, exhibitors and/or sponsors so I may be informed about symposiums at the BC Cancer Summit, November 16-18, 2023

Yes No

*required information
Detailed program agendas are available on the summit website at www.bccancersummit.ca/schedule/.
Registrant Information The following information will be used for the name badges and is required for payment.
First Name		Last Name
Business Telephone (Ext.)
Mobile Phone
City		Province/State
Country
Organization
Department/Program
Job Title (optional)
Please select a professional discipline from the drop down list. We are gathering this information for statistical purposes only
Professional Discipline
Student affiliated company/organization
Department/Program
Supervisor Name
Are you a physician?	Yes No
Are you submitting a poster?	Yes No
Business Email address	Your electronic receipt will be sent to this email address
Access Code	Invited speakers, sponsors, or authorized registrants only

http://www.bccancersummit.ca

Sheraton Wall Centre - Reserve Your Room