Contact us
News
Français
Search
My child has cancer
At the diagnosis
Services Available during Illness
Survivor Support
Palliative Care and Bereavement Support
Information on Childhood Cancer
Testimonials
Impact of your donations
fight cancer
Comfort, Inform, and Guide
Alleviate Pain
Break Families out of their Isolation
Financial Assistance
Our allies
Our Patron
Our partners with a big heart
Our volunteers
Our lucky stars
40 Giants
The Leucan Defenders
Awards and Recognition
About
About Leucan
Board of Trustees and governance
Team
Annual reports and publications
Annual general meeting
News
Contact us
Get involved
Organize a fundraiser
Volunteer
Calendar
Shop for Leucan
Donate
Donate now
Planned and legacy giving
Corporate giving
Home
Annual General Meeting 2022
Annual General Meeting 2022
Annual General Meeting 2022 - Registration
ADULT – PARTICIPANT 1
Information of the family contact person.
Title
*
Mrs.
Mr.
Mx.
Name
*
Name
Surname
Address
*
City
*
Postal Code
*
Phone (home)
*
Mobile
E-mail
*
Allergies/ dietary restrictions
*
ADULT – PARTICIPANT 2
Will you be accompanied by another adult?
*
Yes
No
Title
*
Mrs.
Mr.
Mx.
Name
*
Name
Surname
Allergies/ dietary restrictions
*
CHILD(REN) PRESENT FOR THE DAY
Will you be accompanied by children?
*
No
One child
Two children
Three children
Name of Child 1
*
Name
Surname
Age of Child 1 (as of September 21, 2022)
*
Allergies / dietary restrictions of Child 1
*
Name of Child 2
*
Name
Surname
Age of Child 2 (as of September 21, 2022)
*
Allergies / dietary restrictions of Child 2
*
Name of Child 3
*
Name
Surname
Age of Child 3 (as of September 21, 2022)
*
Allergies / dietary restrictions of Child 3
*
ACCOMODATIONS FOR FRIDAY, 23rd SEPTEMBER
Only offered for participants living 250 km or more from Hotel & Suites Le Dauphin
Do you live 250 km or more from the Hotel & Suites Le Dauphin Drummondville?
*
Yes
No
Hotel address: 600, Boulevard St-Joseph, Drummondville, Québec, J2C 2C1
Do you need accommodation for Friday night?
*
Yes
No
Breakfast and lunch included, provided by Leucan.
Please indicate the number of adults
*
Please indicate the number of children
*
DINNER AND DANCE PARTY - SATURDAY 24th SEPTEMBER
Please indicate the number of adults who will participate
*
Please indicate the number of children who will participate
*
ACCOMODATIONS FOR SATURDAY 24th SEPTEMBER
Do you need accommodation on Saturday night?
*
Yes
No
Please indicate the number of adults who will participate
*
Please indicate the number of children who will participate
*
BREAKFAST - SUNDAY 25th SEPTEMBER
Please indicate the number of adults who will participate
*
Please indicate the number of children who will participate
*
COMMENTS
Any comments? Leave your thoughts in the field below.
Partners
All our partners