DELEGATE REGISTRATION STEP 1

Delegate Registration Step 1

2025 Alberta Dental Team Summit

Welcome to Delegate Registration. To start please provide your personal details below and then proceed to step 2.

Required fields are denoted by a *

Registration Type*

Title*

First Name*

Last Name*

Preferred Badge Name Please write as you would like to appear on badge - leave blank to use your first and last name

Organization/Clinic Name*

Title/Position* Dentist, Hygenist, Office Manager, etc

Address*

City*

Province/State*

Postal Code/Zip*

Country*

Phone Number*

Email Address* Please enter a unique email address for each registrant to receive the Everything DISC Workplace Assessment and other important event updates.

Alternate Email Address Use this field to add an alternate email that will be notified about details related to this registration

Additional Details

Do you have any allergies or special dietary needs like gluten free, nut allergy or celiac that we need to be aware of? Note: please identify yourself to the venue staff at the event if you require a special meal.

Do you require accessibility support?

Are you interested in activities for children that will be traveling with you?

Are you interested in activities for spouses that will be traveling with you?

Do you give permission for the conference organizers to share that your organization is attending the conference?

Please RSVP for the following events:

Help us avoid food waste by letting us know if you will be attending these events. All the following events are included in your registration fee.

Friday Breakfast Keynote

Friday Lunch

Friday Night Social

Saturday Breakfast

Saturday Roots & Bonds Special Luncheon Event

Proceed to Step 2