ImNO Symposium 2023 Registration

21^ST ANNUAL IMAGING NETWORK ONTARIO SYMPOSIUM

MARCH 23 - 24, 2023

DOUBLETREE BY HILTON, LONDON ONTARIO

Group Registration

If you are planning to register a group of people to the symposium, fill in the first person's registration information below and then press SUBMIT. On the next page, press the REGISTER ANOTHER PERSON button and then fill out the registration information for the second person. Continue this procedure until you have added the final person to your group. Make your group payment.

If you have any questions or concerns, please email Kitty Wong (kitty.wong@imno.ca)

Western/Robarts Registrants using Speed Codes

If you are paying with your Western/Robarts speed code, your registration is considered complete once your press the "submit" button. You do not need to pay. You will continue to see a "balance due" on your registration summary page until we can process your speed codes in early March. We will contact you if we have issue with your speedcode.

*NOTE

After you press the "submit" button, a registration confirmation email will be sent to you instantaneously. If you do not receive such an email, please contact us and we will re-send the confirmation email via another channel. Some universities are blocking emails sent from the registration site. Please do not re-register.

REGISTRATION FORM

PERSONAL INFORMATION

*First Name

*Last Name

*Gender

Man
Woman
Non-binary
Prefer not to say
Other

*Institution/Organization

*Role

Undergraduate Student
Master Student
Ph.D. Student
Medical Student
Post-doctorate Fellow
Faculty
Clinician
Industry
Other

*Job Title

Supervisor (if applicable)

*Address 1

Address 2

*City

*Province/State

*Country

Region/County if outside of Canada/USA

*Postal / Zip Code

*Telephone Number (include area code)

Cell Phone Number

*Email

*Confirm Email

*Are you giving a presentation?

Yes
No

REGISTRATION FEES

Regular Registration Fee – up to March 1, 2023	$200.00
Late Fee – March 2 - 24, 2023	$250.00

REGISTRATION FEE
$200.00 CAD

For Western/Robarts ONLY: If you wish to charge your registration to a Western speedcode, please enter it here. You will not have to complete the online payment section on the next page.

If you have a registration code, enter it here

LIABILITY WAIVER AND CANCELLATION POLICY

* I agree and acknowledge that I am undertaking participation in any or all ImNO Symposium Events as my own free and intentional act and I am fully aware that possible physical injury might occur to me as a result of my participation in these events. I give this acknowledgment freely and knowingly and that I am, as a result, able to participate in any or all ImNO Symposium Events and I do hereby assume responsibility for my own well-being. I also agree not to allow any other individual to participate in my place.

* By registering for the ImNO 2023 Symposium, I agree to pay the full amount of the registration fee that I have selected. The registration fee is non-refundable.

ImNO CODE OF CONDUCT

* I acknowledge I have read the ImNO Code of Conduct (https://imno.ca/code-conduct) and understand the expectations for all participants including speakers, attendees, sponsors, exhibitors, volunteers and staff. Help us promote a safe and enjoyable ImNO Symposium experience.

PERMISSION TO RECORD

* I agree to allow ImNO to record and subsequently rebroadcast my participation at the meeting, including my questions and my response to questions.

*Please choose at least one fee before continuing

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