Provincial Fitness Unit of Alberta presents

Fit Rendezvous 2011 June 10 - 12, 2011
Name:
AFLCA ID Number:
Address:
City: Province: Postal Code:
Phone (Business): Home: E-Mail:
Register me in the following sessions:
FRIDAY, JUNE 10 PRE-CONFERENCE REGISTRATION (Please check off the session/s you are registering in)
9:00 am – 10:30 am TRX® Advanced Concepts in Foundational Movements $40.00
10:45 am – 12:15 pm TRX® Circuits for Metabolic Training $40.00
10:45 am – 2:45 pm Functional Independence Training for Older Adults $80.00
1:00 pm – 3:00 pm TRX® Power Stretch $53.00
3:15 pm – 6:15 pm Sports Injury Management and Rehabilitation For Personal Trainers $80.00
6:30 pm – 9:30 pm CPR Recertification $35.00
SESSION CHOICES:
Total Pre-Conference Amount
Indicate 1st, 2nd, and 3rd choice. Use session code numbers to identify choices.
Session requests are filled according to date received.
1st Choice
(Session Code Numbers)
2nd Choice
(Session Code Numbers)
3rd Choice
(Session Code Numbers)
SATURDAY, June 11
7:30 am – 8:45 am Keynote – Unlock Your Potential – Peter Twist
Block 1
Block 2
Block 3 (Aquatic)
Block 4
Block 5
SUNDAY, June 12
Block 6
Block 7
Block 8
Block 9
Block 10 (Aquatic)
PRE-CONFERENCE REGISTRATION:
Total Pre-Conference Amount (from Above)
$
CONFERENCE REGISTRATION:
Advanced Registration
on or before May 6, 2011
AFLCA
NON-AFLCA
$220.00 $270.00
Regular Registration
after May 6, 2011
$270. 00 $330.00
Add $10 for faxed or mailed registrations
Plus 5% GST GST Registration No.: R108102831
$
$
$
$
VISA
Credit Card No:
Expiry Date:
Signature:
MASTERCARD
Total fee enclosed:
$
If Your Employer is Paying for Your Registration: Regardless of who is paying for your registration, payment MUST accompany your registration.
Registration without payment will not be processed. Purchase orders or invoicing are not permitted. Payments must be received by the deadlines in order to qualify for
advanced registration discounts. Receipts are issued in the name of the conference delegate – no exceptions.
Fit Rendezvous 2011 – Waiver of Liability: In consideration of accepting this registration I, the undersigned, intend to be legally bound, for my heirs, my
executors, administrators and myself, waive and release any and all rights and claims for damages I may have against the Provincial Fitness Unit, the facilities, and all
promoters, sponsors and their representatives, successors and their assigns for any and all injuries suffered during the Fit Rendezvous 2011 conference. I verify that I have
been involved in a physical training program and that I am physically fit and do not suffer from any disability, physical ailment and am not taking any medication that
would cause me harm or limit my participation.
Photography Release Form: I hereby grant the Provincial Fitness Unit the irrevocable and unrestricted right to use and publish photographs of me, or of which I
may be included, for publication, electronic reproductions (web sites) and/or promotional materials or any other purpose and in any other manner or medium. In addition,
I grant my permission to alter the same without restriction, and to copyright the same. I hereby release the photographer and the Provincial Fitness Unit from all claims
and liability related to said photographs.
Date: June 10 – 12, 2011
Name (Print):
13
Signature: