Registration Form
*Please copy pages and submit with your registration fee to be submitted to [email protected]
Please print legibly as your name tag will be generated from the information below.
Name:______________________________________ CSMTA Member #:________________________
Address:____________________________________________________________________________
Phone: (H)___________________ (B)______________________ (C)___________________________
Email:_____________________________________________________________________________
Profession: (Circle One) RMT / Physio / AT / Chiro / Osteo / Student / Other:_______________________
Conference Registration Fees
Annual General Meeting - Guest Presenter Melina Kurtakis BHK, MPT, CAFCI - Social
CSMTA Member/Student! ! Non-Member (non-members can attend the AGM but can not vote)
Free ______! ! ! ! $10.00 ______
ATTENTION: We will have some appetizers and beverages for the social. If you have any food allergies
please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
COURSE Offered:
CSMTA’s Advanced Sport Massage Course - 14 CEC - More Information Page 5
Includes Lunch Each Day ($30.00 value) Saturday May 27, 2017, 9:30am-5:30pm. Sunday May 28, 2017,
9:00am-5:00pm
Early Bird Registration Fees! CSMTA Member/Student! Bring Table! Non-Member! Bring Table
(If paid before May 01, 2017) $400.00 ______! ! Yes / No! $425.00 ______ Yes / No
Regular Registration Fees! ! CSMTA member/Student! Bring Table! Non-Member Bring Table
(If paid after May 01, 2017) $425.00 ______! Yes / No $450.00 ______ Yes / No
2
Advanced Sport Massage Therapy Lunch Options (If you are attending course you must choose
Saturday and Sunday’s Lunch).
1) Saturdays Menu: Sandwich and Salad Lunch Buffet
- Harvest Vegetable Salad
roasted butternut squash and carrots, cubed beets chick peas and quinoa over heritage mixed greens, apple
cider honey mustard vinaigrette
- Thai Noodle Salad
egg noodles, edamame, asian coleslaw, cucumbers, and broccoli over heritage greens with sesame soy
vinaigrette
PLEASE CHOOSE A SANDWICH (If you would like more than one sandwich it will be $6.99)
______ Smoked turkey on ciabatta: smoked cheddar, tomatoes, iceberg lettuce and basil mayo
______ Mediterranean vegetable wrap: feta, hummus, cucumber, tomato,kale, spring mix and pesto
______ Roast beef: cheddar cheese, tomato, sautéed onion, dijon mustard, mayo, multigrain baguette
______ Grilled chicken salad on baguette: chicken breast, celery, cucumber, sunflower seeds greens, tomato
______ I would like an additional sandwich: ______________________________________
ATTENTION: if you have any food allergies please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
2) Sundays Menu:
Harvest Vegetable Salad:
roasted butternut squash and carrots, cubed beets chick peas and quinoa over heritage mixed greens, apple
cider honey mustard vinaigrette
Chef Salad:
spring mix, red onion, grape tomatoes, hard boiled egg, cheddar and cucumber over heritage greens with
champagne herb vinaigrette
PLEASE CHOOSE A Wrap (If you would like more than one wrap it will be $6.99)
_____ Mediterranean vegetable wrap: feta, hummus, cucumber, tomato, kale, spring mix and pesto
! (served chilled)
_____ Asian noodle wrap: sweet chili noodles, asian coleslaw, grilled tofu, mixed greens, cucumber
! and sesame (served chilled)
_____ Bang-bang chicken wrap: grilled chicken, Thai red curry rice, spinach, pickled vegetables,
! cucumber and cilantro (served hot)
_____ Chipotle chicken wrap: grilled chicken, chipotle mayo, roasted tomatoes, cheddar cheese
! (grilled and served hot)
_____ I would like an additional sandwich: ______________________________________
3
ATTENTION: if you have any food allergies please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
NOTE: A 25% fee will be charged for any cancellation after 14 days before event
Method of payment is by cheque:
Please make all cheques to: !! ! ! S.M.A. Sport Massage Association of BC
Please mail payment and registration form to: ! BC Chapter - CSMTA
! ! ! ! ! ! ! C/O Brandy Osborne
! ! ! ! ! ! ! 555 Knowles Road
! ! ! ! ! ! ! Kelowna, BC
! ! ! ! ! ! ! V1W 1H4
Other Information:
- There is a lot of free parking at this venue.
- There is also a Starbucks that is within the venue for all your coffee and snack needs. You can not
bring any outside food into the course.
- More information will be sent out to those attending course.
- The AGM - Social - Presentation - ASM Course will all be in - Vancouver A and B Meeting Room -
There will be staff to guide you at the front desk.
*Please copy pages and submit with your registration fee to be submitted to [email protected]
Please print legibly as your name tag will be generated from the information below.
Name:______________________________________ CSMTA Member #:________________________
Address:____________________________________________________________________________
Phone: (H)___________________ (B)______________________ (C)___________________________
Email:_____________________________________________________________________________
Profession: (Circle One) RMT / Physio / AT / Chiro / Osteo / Student / Other:_______________________
Conference Registration Fees
Annual General Meeting - Guest Presenter Melina Kurtakis BHK, MPT, CAFCI - Social
CSMTA Member/Student! ! Non-Member (non-members can attend the AGM but can not vote)
Free ______! ! ! ! $10.00 ______
ATTENTION: We will have some appetizers and beverages for the social. If you have any food allergies
please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
COURSE Offered:
CSMTA’s Advanced Sport Massage Course - 14 CEC - More Information Page 5
Includes Lunch Each Day ($30.00 value) Saturday May 27, 2017, 9:30am-5:30pm. Sunday May 28, 2017,
9:00am-5:00pm
Early Bird Registration Fees! CSMTA Member/Student! Bring Table! Non-Member! Bring Table
(If paid before May 01, 2017) $400.00 ______! ! Yes / No! $425.00 ______ Yes / No
Regular Registration Fees! ! CSMTA member/Student! Bring Table! Non-Member Bring Table
(If paid after May 01, 2017) $425.00 ______! Yes / No $450.00 ______ Yes / No
2
Advanced Sport Massage Therapy Lunch Options (If you are attending course you must choose
Saturday and Sunday’s Lunch).
1) Saturdays Menu: Sandwich and Salad Lunch Buffet
- Harvest Vegetable Salad
roasted butternut squash and carrots, cubed beets chick peas and quinoa over heritage mixed greens, apple
cider honey mustard vinaigrette
- Thai Noodle Salad
egg noodles, edamame, asian coleslaw, cucumbers, and broccoli over heritage greens with sesame soy
vinaigrette
PLEASE CHOOSE A SANDWICH (If you would like more than one sandwich it will be $6.99)
______ Smoked turkey on ciabatta: smoked cheddar, tomatoes, iceberg lettuce and basil mayo
______ Mediterranean vegetable wrap: feta, hummus, cucumber, tomato,kale, spring mix and pesto
______ Roast beef: cheddar cheese, tomato, sautéed onion, dijon mustard, mayo, multigrain baguette
______ Grilled chicken salad on baguette: chicken breast, celery, cucumber, sunflower seeds greens, tomato
______ I would like an additional sandwich: ______________________________________
ATTENTION: if you have any food allergies please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
2) Sundays Menu:
Harvest Vegetable Salad:
roasted butternut squash and carrots, cubed beets chick peas and quinoa over heritage mixed greens, apple
cider honey mustard vinaigrette
Chef Salad:
spring mix, red onion, grape tomatoes, hard boiled egg, cheddar and cucumber over heritage greens with
champagne herb vinaigrette
PLEASE CHOOSE A Wrap (If you would like more than one wrap it will be $6.99)
_____ Mediterranean vegetable wrap: feta, hummus, cucumber, tomato, kale, spring mix and pesto
! (served chilled)
_____ Asian noodle wrap: sweet chili noodles, asian coleslaw, grilled tofu, mixed greens, cucumber
! and sesame (served chilled)
_____ Bang-bang chicken wrap: grilled chicken, Thai red curry rice, spinach, pickled vegetables,
! cucumber and cilantro (served hot)
_____ Chipotle chicken wrap: grilled chicken, chipotle mayo, roasted tomatoes, cheddar cheese
! (grilled and served hot)
_____ I would like an additional sandwich: ______________________________________
3
ATTENTION: if you have any food allergies please inform us, and we will make modifications.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
NOTE: A 25% fee will be charged for any cancellation after 14 days before event
Method of payment is by cheque:
Please make all cheques to: !! ! ! S.M.A. Sport Massage Association of BC
Please mail payment and registration form to: ! BC Chapter - CSMTA
! ! ! ! ! ! ! C/O Brandy Osborne
! ! ! ! ! ! ! 555 Knowles Road
! ! ! ! ! ! ! Kelowna, BC
! ! ! ! ! ! ! V1W 1H4
Other Information:
- There is a lot of free parking at this venue.
- There is also a Starbucks that is within the venue for all your coffee and snack needs. You can not
bring any outside food into the course.
- More information will be sent out to those attending course.
- The AGM - Social - Presentation - ASM Course will all be in - Vancouver A and B Meeting Room -
There will be staff to guide you at the front desk.