Registration

General Contact Information

Fee for late registration is $75 First Name Last Name Gender MaleFemale Address City Province Postal Code Phone Number E-mail

Emergency Contact Information

First Name Last Name Evening Phone Daytime Phone

University Information

University Affiliation Major Year of Study ProfessorYesNo

Accommodations

IMPORTANT: For on campus accommodations, please call Conference Services at either 403-329-2417 (Melissa Bremner) or 403-329-2650 (Melissa Wiebe)


Name of Hotel (if any) Phone Number Room Number (if applicable)

Other

Would you like to attend the final awards banquet the evening of May 8th? An additional fee of $10 is applicable to the regular registration fee if yes. YesNo Any special dietary conditions?Vegetarian Vegan Lactose Intolerant Celiac Other Other Concerns

Disclaimer

_{The Chemistry & Biochemistry Club, The University of Lethbridge Student's Union, The University of Lethbridge and its directors, officers, employees, agents and volunteers (hereinafter referred collectively as 'the Releasees') cannot assume responsibility for the safety and security of any articles of any kind brought into the conference facilities by conference participants. The conference participant shall take all necessary precautions to prevent any loss or damage to their property and the property of others. Additionally, the Releasees cannot assume responsibility for the conditions of the offsite conference venues and premises, nor for the providers of any food and beverage services or for any accommodations. The conference participant acknowledges that they are responsible for their own health, dental, disability and property insurance and by submitting the Western Canadian Undergraduate Chemistry Conference (WCUCC) registration the conference participant agrees to indemnify, release and hold harmless The Releasees from any claim, liability, loss, costs, expense or demand, including legal fees, which may be associated with my participation and attendance at the WCUCC.} By submitting my registration, I have read, understand, and agree to the above terms and conditions.

FOIP

_{ALBERTA Freedom of Information and Protection of Privacy Act (FOIP): By submitting the WCUCC conference registration the conference participant consents to having the information in the registration document collected by the Chemistry & Biochemistry Club and The University of Lethbridge Students' Union and the University of Lethbridge. The personal information requested on the registration document is collected under the authority of the Post Secondary Learning Act and of the Alberta FOIP Act to determine participation in the conference. Certain personal information may be made available to federal and provincial government departments and agencies under appropriate legislative authority. Conference Participant personal information is protected under the Alberta FOIP Act. For further information, contact Director of Governance, University of Lethbridge, A759 University Hall, 4401 University Drive, Lethbridge Alberta, Canada, T1K 3M4, (403) 329-2201.}