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Registration

Registration

DEALER MEMBER REGISTRATION ONLY

Non dealer member registrations will be cancelled and refunded, less a $75 administration fee

1st Registrant – $650

Additional Registrant – $600

Spousal Fee – $400 (includes all meals and cocktail receptions)

Spousal Fee – $250 (Welcome Reception & Gala dinner only)

GST extra

No refunds will be issued after August 19^th. Requests for refunds must be via email and sent to Denise @ dkubin@mdaalberta.com.

Register Now

Dealer Name*
Contact Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Enter Email Confirm Email
Registrant #1 Information
Registrant #1 Name*
First Last
Registrant #1 Title*
Registrant #1 Email*
Registrant #1 Dietary Requests*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Home Many Additional Registrants?
Registrant #2 Information
Registrant #2 Name*
First Last
Registrant #2 Title*
Registrant #2 Email*
Registrant #2 Dietary Requests*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Registrant #3 Information
Registrant #3 Name*
First Last
Registrant #3 Title*
Registrant #3 Email*
Registrant #3 Dietary Requests*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Registrant #4 Information
Registrant #4 Name*
First Last
Registrant #4 Title*
Registrant #4 Email*
Registrant #4 Dietary Requests*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Registrant #5 Information
Registrant #5 Name*
First Last
Registrant #5 Title*
Registrant #5 Email*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Registrant #6 Information
Registrant #6 Name*
First Last
Registrant #6 Title*
Registrant #6 Email*
Add Spouse
- Yes, Gala Dinner Only (+$250)
- Yes, All Meals & Cocktail Receptions (+$400)
Spouse Name*
Spouse Dietary Restrictions*
Registration #1 Price
Price:
Spouse #1 Price
Price:
Spouse #1 Price
Price:
Registration #2 Price
Price:
Spouse #2 Price
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Spouse #2 Price
Price:
Registration #3 Price
Price:
Spouse #3 Price
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Spouse #3 Price
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Registration #4 Price
Price:
Spouse #4 Price
Price:
Spouse #4 Price
Price:
Registration #5 Price
Price:
Spouse #5 Price
Price:
Spouse #5 Price
Price:
Registration #6 Price
Price:
Spouse #6 Price
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Spouse #6 Price
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Subtotal
Price: $ 0.00 CAD
GST 5%
Price: $ 0.00 CAD
SUMMIT REGISTRATION TOTAL
Price: $ 0.00 CAD
Prices include all workshops, meals, and cocktail receptions.
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Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Western Canadian Dealer Summit