Regional Guts - Montreal Registration - Regional Guts - Montreal

I authorize Crohn's and Colitis Canada to use photographs or video images of me taken during my involvement and to use my name, image, comments and information regarding my volunteer role, activities, affiliation and membership and city of residence for purposes of organization in all media and territories in perpetuity. I release Crohn's and Colitis Canada, their sponsors, officers and employees from all liability for any damage or injury resulting from my presence and movement to and from the GUTS 2018 Impact Conference. I agree to protect, release Liability and Indemnity to Crohn's and Colitis Canada and their Sponsors, Agents and Employees against all claims, prosecutions and liabilities arising out of my participation in the Impact 2018 Tournament.

First Name:
Last Name:
Street Address:
City:
Province:
Postal Code:
Phone Number:	( ) - Second three digits Last four digits
Email:
What is your connection to Crohn's and Colitis Canada? :	I am, or know someone who is, living with Crohn's disease or ulcerative colitis I currently volunteer and/or donate to Crohn's and Colitis Canada I have previously volunteered or donated to Crohn's and Colitis Canada I have previously attended a Crohn's and Colitis Canada event (education event, webinar, Gutsy Walk, etc) I regularly visit the Crohn's and Colitis Canada website None of the above
Years of involvement with Crohn’s and Colitis Canada:
Can we share your name and email with other volunteers at Regional GUTS for the purpose of networking?:	Yes No
Dietary restrictions, allergies, accessibility requirements:
I would like to RSVP to the following:	Morning Keynote Luncheon Only Full Day
By registering, I agree I have read and will abide by the above agreements:	I agree and have read and will abide by the above agreements I authorize Crohn's and Colitis Canada to use photographs or video images of me taken during my involvement and to use my name, image, comments and information regarding my volunteer role, activities, affiliation and membership and city of residence for purposes of organization in all media and territories in perpetuity. I release Crohn's and Colitis Canada, their sponsors, officers and employees from all liability for any damage or injury resulting from my presence and movement to and from the GUTS 2018 Impact Conference. I agree to protect, release Liability and Indemnity to Crohn's and Colitis Canada and their Sponsors, Agents and Employees against all claims, prosecutions and liabilities arising out of my participation in the Impact 2018 Tournament.

Regional Guts - Montreal

Regional Guts - Montreal Registration

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