Use a PDF Form - HTAC National Conference

Conference Registration Form
April 23-26, 2015 – Nanaimo, BC
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Name (please print clearly):
Address:
City – Prov – Postal Code:
Register online and pay securely using
Paypal at http://conference.htacjm.org/register. NOTE: Paypal charges a
fee of 2.9% + $0.30 per transaction.
OR
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Telephone:
Email:
Mail this form & cheque payable to
Healing Touch Assoc. of Canada to:
Healing Together c/o Ginny Mulhall, 4096
W 8th Ave, Vancouver, BC V6R 1Z6
REGISTRATION FEES (Check appropriate box)
Postmarked by
Jan. 30, 2015
Postmarked by
March 13, 2015
Postmarked after
March 13, 2015
HTAC Member – Full Conference
$300
$325
$350
Non-member – Full Conference
$350
$375
$400
HTAC Member or Non-member – One Day Only
$160
$170
$180
Included in Full Conference fee: light dinner on Friday; cold breakfast on Saturday and Sunday; refreshments.
Conference Fee (enter price from box above)
Banquet Ticket – Number of tickets
$
x $65 ea. =
$
(Pacific Rim Buffet includes salads, chowder, roast of pork, wild salmon, vegetarian pasta and desserts. Cash bar.)
TOTAL:
Payment method:
□
□
$
I’m including a cheque payable to Healing Touch Association of Canada.
I’m paying using Paypal at http://conference.htac-jm.org/Paypal (additional Paypal fees apply).
CHOOSE YOUR WORKSHOP PREFERENCES (For each time frame, circle your choices in order of preference.)
Circle choices in order of preference
FRIDAY, APRIL 24
9 a.m. – 12 p.m.
Amazing You: An Introduction to Yourself! (Jeannette Nienaber)
Relational Touch (Richard Ferguson)
Sacred Self Collage (Michele Fire-River Heart)
SATURDAY, APRIL 25
1
1
1
2
2
2
3
3
3
Circle choices in order of preference
10:15 a.m. – 12:15 p.m.
Wa AH Wiss: Balance the Medicine Wheel Within (Dan and Tony Elliott)
Introduction to the Intuitive Mind Program (Catherine Awai)
Healing Touch for Animals (Annette McQueen)
3:30 – 5:30 p.m.
What Lies Beneath: How to Ask the Creative Questions (Pietro Abela)
Your Healing Journey (Cindy Palajac)
Interconnected: Intimate Examination of Quantum Theory (Elke Nowicki)
1
1
1
2
2
2
3
3
3
Circle choices in order of preference
2
2
2
3
3
3
Circle choices in order of preference
SUNDAY, APRIL 26
10:15 a.m. – 12:15 p.m.
1
1
1
Rituals of Healing (Vicki Slater)
Creative Change (Marlyn Farrell)
Healing Together: The Role of Leadership (Rochelle Graham)
Are you attending the Instructors’ Meeting on April 23 rd? ............................ Yes .............. No
Do you wish to be pinned at the conference? ............................................. Yes .............. No
Are you planning to bring a Silent Auction item? ......................................... Yes .............. No
May your contact information be included in the participant list? ................ Yes ............. No
Do you have food allergies or dietary considerations? ................................. Yes .............. No
If yes, please specify:
1
1
1
2
2
2
Circle
your
choice
CANCELLATION POLICY: In the event of a cancellation
QUESTIONS? Email: HealingTogether2015@shaw.ca
after March 15th, a $50 handling fee will be deducted. If the
cancellation occurs after April 15th, a $150 fee will be deducted.
Phone: Carol Keane | Conference Chair: 250 247 9072
Website: http://conference.htac-jm.org
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3
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Conference Registration Form - April 23-26, 2015 – Nanaimo, BC
Page 2
Conference Schedule for Your Reference
(Note: This schedule is subject to change.)
THURSDAY – Instructors’ Day at the Vancouver Island Conference Centre
8:30 – 9:30 a.m.
10 a.m.
12 – 1 p.m.
4 p.m.
Breakfast meet and greet
Begin session (Facilitator to be determined)
Lunch on your own. Explore seaside Nanaimo!
Conclusion
FRIDAY – At the Vancouver Island Conference Centre
9 a.m. – 12 p.m.
Workshop: Michele Fire-River Heart
Workshop: Richard Ferguson
Workshop: Jeannette Nienaber
12 – 2 p.m.
2 – 3:30 p.m.
Lunch on your own. Explore seaside Nanaimo!
Keynote Speakers: Dan and Tony Elliott
Local vendors will
be offering their
wares all day in
the Conference
Centre Hallway
Opening Ceremony and AGM
6 – 7 p.m.
Simple buffet-style dinner
7 – 8 p.m.
Opening ceremony and welcome
8 – 9 p.m.
AGM
7 – 9 p.m.
Begin ongoing silent auction. Loonie-toonie draw.
SATURDAY – At the Vancouver Island Conference Centre
7:30 – 9 a.m.
8 – 9 a.m.
9 - 10 a.m.
10:15 a.m. – 12:15 p.m.
Healthy breakfast provided
Registration desk is open
Keynote Speaker: Pietro Abela
Workshop: Dan and Tony Elliott
Workshop: Catherine Awai
Workshop: Annette McQueen
12:15 – 1:45 p.m.
1:45 – 3:15 p.m.
Lunch on your own and self care. Explore seaside Nanaimo!
Keynote Speaker: Joel Anderson
3:15 – 3:30 p.m.
3:30 – 5:30 p.m.
Break with refreshments
Workshop: Pietro Abela
Workshop: Cindy Palajac
Workshop: Elke Nowicki
Healing Together Dinner
6:30 p.m.
7 – 9:30 p.m.
8 - 8:45 p.m.
Local vendors will
be offering their
wares all day in
the Conference
Centre Hallway
Cash bar
Pacific Rim Buffet – Final time to bid on silent auction - Loonie-toonie draw - Pinning Ceremony
Keynote Speaker: Alexandra Jonsson
SUNDAY – At the Vancouver Island Conference Centre
7:30 – 9 a.m.
9 - 10 a.m.
Healthy breakfast provided
Keynote Speaker: Catherine Awai
10 - 10:15 a.m.
10:15 a.m. – 12:15 p.m.
Break with refreshments
Workshop: Vicki Slater
Workshop: Marlyn Farrell
Workshop: Rochelle Graham
12:15 – 1 p.m.
Final send off
Local vendors will
be offering their
wares in the
morning in the
Conference
Centre Hallway