Admission Bundle In-Person

First Name*

This field is required.

Ticket Holder #1

Last Name*

This field is required.

Ticket Holder #1

Email*

We need a valid email.

Ticket Holder #1: Your ticket will be emailed to you. Please make sure your email address is correct.

How Do You Identify Yourself?*

This field is required.

Ticket Holder #1: Please select the option that best describes your relationship with those impacted by an acoustic neuroma

If diagnosed, what is your stage of treatment?

This field is required.

Ticket Holder #1

Dietary Requirements

This field is required.

Ticket Holder #1: Please let us know if you have any dietary requirements and our caterers will do their best to accommodate

Event Photo & Video Release** Opt-Out Option

Ticket Holder #1: I do not agree to the photo and video release and prefer not to be photographed or videotaped

First Name*

This field is required.

Ticket Holder #2

Last Name*

This field is required.

Ticket Holder #2

Email*

We need a valid email.

Ticket Holder #2: Your ticket will be emailed to you. Please make sure your email address is correct.

How Do You Identify Yourself?*

This field is required.

Ticket Holder #2: Please select the option that best describes your relationship with those impacted by an acoustic neuroma

If diagnosed, what is your stage of treatment?

This field is required.

Ticket Holder #2

Dietary Requirements

This field is required.

Ticket Holder #2: Please let us know if you have any dietary requirements and our caterers will do their best to accommodate

Event Photo & Video Release** Opt-Out Option

Ticket Holder #2: I do not agree to the photo and video release and prefer not to be photographed or videotaped

**Event Photo and Video Release

We may take photographs and videos during the event for promotional purposes, including on social media, our website, and other marketing materials. By participating in the event, you agree to grant Acoustic Neuroma Association of Canada (ANAC) permission to use your likeness in photographs and videos for these purposes. The virtual session will be recorded and made available to all event registrants.

If you do not wish to be photographed or videotaped, please select the "Opt-out Option". For in-person attendees, we will indicate your preference on your name badge. For virtual attendees, we will notify the Zoom moderator and will ask that you turn your camera off while in session.

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Admission Bundle In-Person