Annual Conference Registration

Space will fill up quickly so book early to avoid disappointment!

all fields marked with an asterisk (*) are required

Contact Information

First name: *
Last name: *
Company:
Address *
Suite #
City: *
Province/State: *
Country:
Postal/Zip Code: *
Email: *
Phone: *
Fax
Website

Privacy Policy for Conferences

Personal information collected on this form will only be used for purposes of conference administration.

I consent to have my information used to provide me with OPA communications.

Yes No

Fees Selection

Registration Category *

Full Conference (1 reception ticket included)

One Day Friday

One Day Saturday

Fees *

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OPA Member - Full: $

not_early_bird

A PHP Error was encountered

Severity: Warning

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OPA Member Associate/Life/Inactive/ Honorary: $

not_early_bird

A PHP Error was encountered

Severity: Warning

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OPA Member - Resident: $

not_early_bird

A PHP Error was encountered

Severity: Warning

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Medical Students (Student ID required): $

not_early_bird

A PHP Error was encountered

Severity: Warning

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Non Members – Physicians: $

not_early_bird

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Severity: Warning

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Non Members – Allied Health Care Professionals: $

not_early_bird

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Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
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Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
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Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Filename: helpers/MY_form_helper.php

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Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
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Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
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Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
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Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
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Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Filename: helpers/MY_form_helper.php

Line Number: 55

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
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Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

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Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Filename: helpers/MY_form_helper.php

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Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
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Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
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Function: _ci_load

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Function: view

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Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Filename: helpers/MY_form_helper.php

Line Number: 55

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Filename: helpers/MY_form_helper.php

Line Number: 56

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
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Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
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Function: view

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Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Filename: helpers/MY_form_helper.php

Line Number: 55

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Severity: Warning

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Filename: helpers/MY_form_helper.php

Line Number: 56

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
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Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Filename: helpers/MY_form_helper.php

Line Number: 55

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Filename: helpers/MY_form_helper.php

Line Number: 56

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Filename: helpers/MY_form_helper.php

Line Number: 55

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 55
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

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Severity: Warning

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Filename: helpers/MY_form_helper.php

Line Number: 56

Backtrace:

File: /home/opaweb/apps/2024_opa_website/application/helpers/MY_form_helper.php
Line: 56
Function: _error_handler

File: /home/opaweb/apps/2024_opa_website/application/views/annual_conference_registration/form.php
Line: 94
Function: radio_buttons_rates

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 362
Function: include

File: /home/opaweb/apps/2024_opa_website/application/third_party/MX/Loader.php
Line: 304
Function: _ci_load

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 440
Function: view

File: /home/opaweb/apps/2024_opa_website/application/controllers/Annual_conference_registration.php
Line: 126
Function: form

File: /home/opaweb/apps/2024_opa_website/index.php
Line: 346
Function: require_once

Additional reception ticket(s): each $

Payment Information

Subtotal:	0.00
Tax (13% HST) HST #899667364 RT0001:	0.00
Total:	0.00
Name on Card: *
Credit Card Number: *
Expiration (MM/YYYY): *	/
CVC: *

First Name*
Last Name*
Company*
Email:*
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