Mail-in Registration Form – please complete all pages
Please print. *marks required field
*Last Name:
*First Name:
Name of Institution:
Sub-Specialty Interest (if applicable):
* Address:
*City:
*State/Province:
*Postal Code:
*Phone:
*Email:
*Dietary or other special requests/concerns:
Please select your registration type:
□Early Registration $300 (Deadline of August 1, 2017)
□Standard Registration $400
□Residents $125
□Nurses/RTs/AAs $125
Registration includes Welcome Reception and all Breakfast-Break-Lunch meals on Saturday and Sunday.
*Online Registration can be paid with credit card via Paypal. For mail-in registration, please send a cheque
for the full registration amount. Cheques can be made out to D.U.D.A.D.F. (Dalhousie University
Department of Anesthesia Development Fund).
Mail completed form and payment to
Department of Anesthesia, 5th Floor Halifax Infirmary,
Attn: Vicki Christian
1796 Summer Street Halifax, NS B3H 3A7
Mail-in Registration Form Continued – please complete all pages
Will you attend the Welcome Reception on Friday evening (7:30pm on September 22)?
□ No
□Yes, If yes indicate the number of guests: ________
Will you require a dinner reservation on Saturday evening?
*Please note that dinner costs are not included with registration and space may be limited.
□ No
□Yes, If yes indicate the number of guests:
________
Optional activities are listed below. Please indicate appropriately by selecting YES or NO, including the
number of people interested in the activity. Please note that activities are available to all guests, including
family members. Golf is the only activity that requires prepayment and is scheduled for Saturday (tee times
1:00-2:15pm to be assigned). Please indicate if you are interested in one of the activities below and you will
be contacted later with further details. See below for a description of some of the activities.

Golf $225.00 + 15% tax = $258.75 per person per round (cart included)
□ No
□Yes, If yes indicate the number of guests: ________

Sport Shooting (Yes/No/# of people)
□ No
□Yes, If yes indicate the number of guests: ________

Trout Fishing (Yes/No/# of people)
□ No
□Yes, If yes indicate the number of guests: ________

Horse Riding (Yes/No/# of people)
□ No
□Yes, If yes indicate the number of guests: ________

Pontoon Boat (Yes/No/# of people)
□ No
□Yes, If yes indicate the number of guests: ________
Cancellation Policy:
A $50 processing fee will be charged for each refund. Refund requests must be submitted in writing to
[email protected]. Full refunds (minus processing fee) will be provided for requests received in
writing before August 22, 2017. Written requests received after August 22, 2017 will be provided a 50%
refund (after deduction of the processing fee). Registrations cannot be transferred.
Accommodations:
A block of guest rooms has been set aside for September 22 & 23, 2017 at Fox Harb’r. Call 1.866.257.1801
to make a reservation. Be sure to reserve before August 22, 2017 and reference the CAS Atlantic Regional
Meeting when you are making your reservation to ensure the conference rates.
Studio Suite (Single or Double Occupancy) $275
Executive Suite (Single or Double Occupancy) $325
3 Bedroom Townhouse (Up to 4 people) $950
(Plus Applicable Taxes)
Activities:
Saturday Evening Dinner: CAPE CLIFF DINING
Overlooking Fox Harb’r’s 18th green and the beautiful Northumberland Strait, the Cape Cliff Dining Room is
Atlantic Canada’s first sustainable seafood restaurant. Chef Shane Robilliard’s culinary team developed a
seafood focused menu sourcing the freshest sustainable choices. The menu will evolve reflecting the many
fishery options that Nova Scotia is famous for. Join us for a sustainable meal that will leave you wanting to
return.
Spa & Wellness Centre (please call in advance to book)
Description from Fox Harb’r: Whether you are looking for healing hands that can induce a Zen-like slumber
during a massage or the highlysought-out Swiss cellulotherapy, the Spa professionals at Fox Harb'r are
ready to provide an experience where the only thing that matters is your personal well-being. Please refer
to the Spa Menu for current pricing. Beneath our beautiful Spa lies our Wellness Centre, a dynamic fitness
studio and aquatic facility. Dive into the junior Olympic-sized swimming pool and relax in our mineral pool
and hot tub. The Wellness Centre is complimentary for our Resort guests.
Sport Shooting
For the outdoor sporting enthusiast Fox Harb’r offers two Sport Shooting activities. Five Stand Sporting Clay
and a 12 Stand Sporting Clays Course. Sporting Clay is a challenging clay target sport designed to simulate
field shooting. Licensed firearms and ammunition are available to our guests. 5 Stand is available at a cost
of $60.00 plus tax per round, while the Sporting Clays Course is available at a cost of $100.00 plus tax per
round.
Trout Fishing
For the early riser or a relaxing evening activity Fox Harb’r Resort offers Fly or regular fishing in the early
morning or at dusk. With weather permitting, try fishing in one of our two ponds stocked with trout. An
experienced guide and tackle are available for this adventure. Fishing at Fox Harb’r Resort is all catch and
release and is available at a cost of $38.00 per person plus tax for up to 4 hours or $48.00 per person with a
guide plus tax.
Horse Riding
For the ultimate Fox Harb’r experience; take a horseback ride through our extensive and diverse landscape;
$100.00 per person plus tax. Duration 1.5 hours and maximum 4 people at any time. Minimum age 8 years.
Pontoon Boat
Enjoy a scenic ocean boat ride. $210.00 per hour plus tax and $105.00 per additional hour. Or $370.00 for 3
hours. Maximum 10 people at any time and food and beverage available at an additional charge.
Kayaking
Kayaks are available on a first come first serve basis and are complimentary for our Resort guests.
Mountain Biking
Experience the peace and tranquility on the Resort property or venture offsite on one of our Trek Mountain
bicycles. Mountain bikes are located on the exterior, lower level of the Spa & Wellness Centre and are
complimentary for our Resort guests.