2023 Registration Download the Value Letter Registration "*" indicates required fields Step 1 of 2 – Introduction and Contact 50% IMPORTANT NOTESSession option choices will be circulated to registrants in September. 1st choice session options are not guaranteed and are requested for planning purposes only. Sessions will be filled onsite on a first come/first serve basis.Due to the lead time to order printed delegate materials, delegates who register after September 6, 2023 will not be guaranteed an official CANNT/ACITN 2023 delegate bag and/or materials. SPECIAL NOTES• Delegate name and provided email address will be shared with exhibitors• Some sessions may be ticketed and only those delegates pre-registered will be guaranteed seats• Scientific session handouts are provided at the discretion of the individual presenter• Business casual dress is requested• Our conference is fragrance free PRIVACY STATEMENTRegistration information is collected to process registrations and payments for educational events, correspond with registered delegates, and to publish delegate lists for event participants. If you do not wish to have your registration information used for these purposes please indicate this on the registration form. CONSENT TO USE OF PHOTOGRAPHIC IMAGESRegistration and attendance in CANNT 2023 conference constitutes an agreement by the registrant to the Canadian Association of Nephrology Nurses and Technologists (CANNT) to use the registrant’s image in photographs. CONTINUOUS LEARNING ACTIVITY FOR CNA CERTIFICATIONWhile this educational activity is not officially endorsed by the Canadian Nurses Association (CNA), nurses may claim it as a continuous learning (CL) activity toward renewal of the CNA certification credential if it is related to their nursing specialty. Preauthorization from the CNA Certification Program is not required. Participants are encouraged to retain a confirmation of attendance. CANCELLATION / SUBSTITUTION POLICYS• Cancellations will be refunded less 20% administration fee with notice of cancellation being received at cannt@cannt.ca no later than September 6, 2023. No refunds will be issued after this date.• Substitutions may be made; please send notice to cannt@cannt.ca.• CANNT reserves the right to make appropriate program changes as deemed necessary and/or cancel events due to circumstances beyond CANNT’s control. In the event of cancellation of the conference, only registration fees and ticket purchases paid will be refundedRegistration Rates: Full Conference Member $749.00 Non-Member (includes 2-year CANNT membership) $899.00 Student $300.00 Per Day Member Per Day $400.00 Non-Member Per Day $460.00 Student Per Day $160.00 Sponsor-Exhibitor 1Sponsor Complimentary $0.00 2Exhibitor Nametag Complimentary $0.00 Exhibitor Nametag Additional $200.00 Sponsor Full $450.00 1Number of Complimentary registrations determined by sponsorship level 2One complimentary exhibitor nametag per boothContact InformationName* First Last Email* Company/ Organization* Job Title* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Preferred Phone Number*Professional Status* RN NP Technologist Social Worker Pharmacist Technician LPN/RPN Dietician Full-time Student Other (specify below) Other Professional Status (please specify) Area of Practice* Peritoneal Dialysis Pharmacy CKD Pediatrics Education Inpatient Nephrology Hemodialysis Research Transplant Administration Other (please specify) Other Area of Practice (please specify) Is this your first CANNT Conference?* Yes No Emergency ContactEmergency Contact Name Emergency Contact Daytime Phone Emergency Contact Nighttime Phone Emergency Contact Nighttime Email Full Conference Registration includes breakfast, breaks, and lunch each day, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 26. Conference registration does not include the Thursday evening social event or the Friday evening banquet. Daily Registration includes breakfast, breaks and lunch on the day registered. Exhibit Booth Staff Registration includes breakfast, breaks, and lunch on Friday, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 26. Full Access Pass is available at a reduced cost for those company reps that would like to attend the conference’s scientific programming, in addition to fulfilling their booth responsibilities. All fees are subject to HST @ 15% (100759869RT0001)Please enter your registration type*If you are unsure of your membership status, please contact cannt@cannt.ca CANNT Member in good standing Non-member Sponsor Exhibitor Student HiddenDate MM slash DD slash YYYY Member RegistrationFull Conference registration (member rate) QuantityFull Conference Registration includes breakfast, breaks, and lunch each day, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 26. Price: $ 749.00 CAD Quantity Coupon CodeCANNT Board members and Members of the CANNT 2023 Planning Committee Discount $ 0.00 CAD Thursday Only (member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 400.00 CAD Quantity Friday Only (member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 400.00 CAD Quantity Saturday Only (member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 400.00 CAD Quantity Non-member RegistrationNew This Year! Purchase of a Full Conference registration at the non-member rate includes a 2-year CANNT membership. Registrants will be contacted by the CANNT office to activate their membership. Please contact cannt@cannt.ca with any questions.Full Conference registration (non-member rate) includes 2-year CANNT membership QuantityFull Conference Registration includes breakfast, breaks, and lunch each day, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27. Price: $ 899.00 CAD Quantity CANNT Membership IncludedFull Conference non-member registration includes a complimentary two-year membership with CANNT. Please confirm you want to become a CANNT member. Yes No Friday Only (non-member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 460.00 CAD Quantity Thursday Only (non-member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 460.00 CAD Quantity Saturday Only (non-member rate) QuantityDaily Registration includes breakfast, breaks and lunch on the day registered. Price: $ 460.00 CAD Quantity Sponsor-Exhibitor RegistrationSponsor-Exhibitor Registration Entitlements Platinum ($15,000.00) – 4 complimentary full registrations Gold ($10,000.00) – 3 complimentary full registrations Silver ($5000.00) – 2 complimentary full registrations Bronze ($3000.00) – 1 complimentary full registration Exhibit Booth Only – 1 complimentary exhibit booth staff Full Conference Registration includes breakfast, breaks, and lunch each day, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27. Exhibit Booth Staff Registration includes breakfast, breaks, and lunch on Friday, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27.Sponsor Complimentary Full Conference Registration QuantityFull Conference Registration includes breakfast, breaks, and lunch each day, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27. Price: $ 0.00 CAD Quantity Complimentary Sponsor Attendee/ Nametag InformationPlease enter the following information for all attendees. If you are registering multiple attendees click “+” to add another name.Nametag NameCompany/ InstitutionCityemailDietary restrictions Add RemoveExhibitor Nametag Complimentary (one representative per booth) QuantityExhibit Booth Staff Registration includes breakfast, breaks, and lunch on Friday, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27. Price: $ 0.00 CAD Quantity Complimentary Exhibit Booth Staff Nametag InformationPlease enter the following information for all attendees. If you are registering multiple attendees click “+” to add another name.Nametag NameCompany/ InstitutionCityemailDietary restrictions Add RemoveFULL ACCESS Pass for Sponsors and Exhibitors QuantityFull Access Pass is available at a reduced cost for those company reps that would like to attend the conference’s scientific programming, in addition to fulfilling their booth responsibilities. Price: $ 450.00 CAD Quantity FULL ACCESS Pass for Sponsors and Exhibitors Nametag InformationPlease enter the following information for all attendees. If you are registering multiple attendees click “+” to add another name.Nametag NameCompany/ InstitutionCityemailDietary restrictions Add RemoveAdditional Exhibitor Nametag QuantityExhibit Booth Staff Registration includes breakfast, breaks, and lunch on Friday, admission to the exhibit hall, and one ticket to the exhibit hall reception on Thursday October 27. Price: $ 200.00 CAD Quantity Additional Exhibitor Nametag InformationPlease enter the following information for all attendees. If you are registering multiple attendees click “+” to add another name.Nametag NameCompany/ InstitutionCityemailDietary restrictions Add RemoveStudent RegistrationStudent Eligibility In order to qualify for the student rate you must be certified as a full-time graduate student, or not-less-than-half-time undergraduate student. Please submit the completed Student Eligibility Form and return to cannt@cannt.caFull Conference Student QuantityMust be a full time student and submit a student eligibility form. Price: $ 300.00 CAD Quantity Per Day StudentMust be a full time student and submit a student eligibility form. Daily Registration includes breakfast, breaks and lunch on the day registered. Thursday $160.00 Friday $160.00 Saturday $160.00 Registrant Nametag InformationRegistrant Nametag Information*Please enter the following information for all attendees. If you are registering multiple attendees click “+” to add another name.Nametag NameCompany/ InstitutionCityemailDietary restrictions Add RemoveAdditional ItemsThe Thursday Evening Bowling and the Friday Evening of Entertainment are not included in your registration and must be purchased as an additional item. Thursday Social, October 26 You look STRIKING! On Thursday evening, following the Opening Reception in the exhibit hall, delegates can make their way to the bowling alley up the street! Eat. Drink. Bowl. At the Alley! Cost: $14.50 Tickets required. Friday Banquet, October 27 Get ready for a kitchen party to remember! There will be music, seafood – an east coast party! Celebrating PEI’s traditional and contemporary roots music, the Ross Family will present a taste of real Island culture through song and story, bolstered by driving fiddle sets and outstanding stepdancing! Cost: $85.00 Tickets required.Thursday Evening Bowling QuantityThis event is not included in your registration and a ticket must be purchased to attend. Price: $ 14.50 CAD Quantity Please enter the names for the Thursday Evening Social tickets if purchasing for other than yourself. Add RemoveEvening of Entertainment – Friday QuantityThis event is not included in your registration and a ticket must be purchased to attend. Price: $ 85.00 CAD Quantity Please enter the names and dietary restrictions for the banquet tickets if purchasing for other than yourself.NameDietary Restictions Add RemoveOne ticket for the Thursday Exhibit Hall Reception is included in your registration. If you require extra guest tickets, you my purchase below. Exhibit Hall Reception Thursday – Extra Tickets QuantityOne ticket is included in your registration (except single day) – Choose only if you require extra tickets or are registering for a single day and wish to attend. Price: $ 40.00 CAD Quantity HiddenExhibit Hall Reception – Extra TicketsPlease enter the name(s) for additional Thursday Reception ticketsNameCompanyDietary Restrictions Add RemoveCheckoutConsent to share personal information*Registration information is collected to process registrations and payments for educational events, correspond with registered delegates, and to publish delegate lists for event participants. In the case of non-member full conference registrations, this information will be used for your included CANNT membership registration. If you do not wish to have your registration information used for these purposes, please indicate this on the registration form. Yes No Subtotal $ 0.00 CAD HST @ 15% (100759869RT0001) $ 0.00 CAD Total Payment Method* I will pay by credit card I would like to be invoiced to pay by another method Credit CardCard Details Cardholder Name
