LAI 2025 Montreal Gathering

How many people are you registering? *

All contact information must be for the person being registered—especially the e-mail address. Provide the contact information at which the registrant prefers to be contacted during business hours. The information provided here will overwrite the registrant’s existing contact record.

Registrant Contact Information

First Name *

Last Name *

Designation(s)

Accreditations to be listed after the last name, such as PhD

Job Title

Organization

Address *

Address 2

City *

Country *

State/Province *

Postal Code *

Number to receive informational texts during the event.

Cell Phone *

Email *

Chapter

Emergency Contact Name and Phone *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Registrant Dietary, Accessibility and Other Preferences

Other Dietary Restrictions

Special Accommodations

PLEASE NOTE: By nature of your attendance, you are granting permission for your basic contact information to be shared with our sponsors and/or exhibitors unless you opt out here.

Registrant Privacy Options

Do NOT share my basic contact information with the sponsors and/or exhibitors

PLEASE NOTE: Casual audience photographs may be taken and utilized for marketing purposes. By nature of your attendance you are granting permission of your image to be used by LAI for our internal promotion as we see fit.

Gluten Free	Kosher	No dairy	No red meat
No seafood/shellfish	Vegan	Vegetarian	Other

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