* - required fields
Contact Information
(as it will appear on your Name Badge)

please check one
First Name:*
Last Name:*
Position / Title:*
Organization / Hospital:*
Postal/Zip Code:*

Please enter valid Email Address as this is required to send Receipt and Confirmation Notice

Tell us if you have Dietary Concerns:

By May 31th, 2013
After May 31th , 2013
Physician (Active)
Physician (Associate)
/Resident/Fellow/Allied Health

NB: Full Conference includes one (1) year membership in CABPS effective July 1, 2013.

Included in Conference registration:
  • 2 Breakfasts, 3 Breaks and 1 Lunch
  • Conference materials
  • Access to Presentations Online
  • Access to members only area of CABPS website
  • Invitations to other sponsored events
  • CABPS e-newsletter
  • President's Banquet dinner

President's Banquet (Dinner subsidized by CABPS) will be held on Friday, June 14th. Everyone is welcome to attend! *

I will attend I will not attend

Annual General Meeting of CABPS Members - Saturday, June 15, 2013 (Breakfast included.) *

I will attend I will not attend

Payment Information
TOTAL REGISTRATION FEES: (All figures in Canadian currency)
Total Fees $

   (Please note: all credit card charges will appear under the name of CMAS)

Please register by May 31, 2013 to receive discounted registration fees. All fees are in Canadian Dollars.

Registration & Cancellation Policies
  1. Your registration will not be processed until full payment is received.
  2. Notice of cancellation must be made in writing. A $100 cancellation fee will apply for registrations cancelled up to May 31, 2013. After May 31, 2013 no refunds will be issued, substitutions only. All substitutions MUST be made in writing.
  3. Confirmation notice of your registration and receipt will be sent to you upon registering online. If you register by mail or fax a confirmation notice will be sent to you within 10 business days of full payment. If you do not receive your confirmation within this time frame, please contact the Event Registrar, Arlene Morgan, at (1-905) 522-1155 ext 35144.
  4. Registration forms received by fax or mailed, receipts will be emailed if received by May 31, 2013. Receipts for registrations received after this date will be given to you in your delegate package at the meeting
  5. Advance registrations will be accepted up to May 31, 2013.

Privacy Policy

Your contact information as provided above will be included in the Conference Program. Your full name, address, phone, fax, and email will be printed in a roster format to be presented to all registered delegates attending the CABPS Annual Conference to be held June 14-15, 2013. This information will not be used for any other purpose OBN, McMaster University, CABPS or CMAS. *

 Yes, I give consent   No, I do not give consent

Photo Policy

In registering for the Conference, you acknowledge that photos or images of you may be taken during the course of the event. You further acknowledge that these photos may be used for promotion of this and future events and may appear on the CABPS website. They will be used solely for the purposes of CABPS.