2015 Canadian Youth Against Impaired Driving National Conference Fredericton, New Brunswick May 21st – 23rd, 2015 TADD New Brunswick is pleased to invite you to join us for the upcoming Canadian Youth Against Impaired Driving National Conference. We are a group of dedicated Students and Volunteers who strive to bring the message home to our youth year after year. That message is “FRIENDS DON’T LET FRIENDS DRINK AND DRIVE”. You can visit us on the web at www.taddnb.com Welcome to the 2015 National CYAID Conference. Registration forms are attached. CONFERENCE INFORMATION CONFERENCE DATES: May 21st – 23rd, 2015 CONFERENCE LOCATION: Fredericton NB REGISTRATION All official registration forms will be on our website and are included in this package. You must use these forms to register. Please keep reading so you are aware of the requirements and arrangements. DEADLINE FOR REGISTRATON: April 24th, 2015 WHERE TO SEND YOUR REGISTRATION Attention: TADD NB 383 French Village Road Quispamsis, NB E2S 0C4 CONFERENCE CONTACT The conference coordinator for TADD NB is Sarah Cormier - McHugh. All contact can be made via email to [email protected] by telephone at (506)636-2324. If required to leave a message, please be sure to leave your name, contact phone numbers, including area code and a brief message regarding your inquiry. ADULT ADVISORS All groups of delegates attending CYAID 2015 must attend with an adult advisor. An adult advisor is the ‘adult’, over the age of 18, who is FULLY responsible for the delegates that are attending with their group at all times. They accept full responsibility for their delegates; for supervision, behaviour, medical needs, etc. TADD NB does not coordinate any supervision or accept any responsibility for delegates. CONFERENCE ACCOMMODATIONS All accommodations will be booked by TADD NB – CYAID 2015 organizers. Accommodations will be on the University of New Brunswick Campus, Fredericton (UNB). Accommodations will be blocked for your delegation once we have received payment. The rooms are dormitory rooms with 2 single beds per room, or a single at an additional fee. PLEASE NOTE: You will need to bring your own Towels and Sundries. REGISTRATION Registration will be accepted from February 1st through April 24th, 2015. We shall process registrations that are received in the mail – with full payment – on a first-come - first serve basis. We will NOT HOLD SPACE in anticipation of your attendance. You will receive an email confirmation within 5 business days of receipt of your registration and payment. You must use the ‘official’ registration form, which enables us to process your registration efficiently. Please be sure all required fields are completed in full. We will not accept any registrations without payment. Late registrations will be accepted upon individual review and space availability. If you require an extension to this deadline – please contact us at [email protected]. ACCOMMODATION We will book accommodations in the following occupancy categories ONLY: 1. Single Occupancy with one person in the room. 2. Double Occupancy with two people in the room and two beds (a bed each). The rooms are dormitory rooms with 2 single beds per room. *If you have a single delegate, that you cannot block in with other delegates from your group, please request double occupancy and we will partner them up with one more individual delegate from another group, therefore each person having their own bed (Only if this option is available). Keep this in mind when preparing your delegates list for the conference; it is our STRONG RECOMMENDATION to bring delegates that can fill all of your own rooms - rather than having to have rooms completed with delegates from other schools. CONFERENCE FEES The following is the breakdown of pricing for CYAID 2015. The prices listed are PER PERSON. All fees are based upon the occupancy in the rooms. All accommodations will be arranged by TADD NB. The conference fee includes all conference costs starting on Thursday and concluding Sunday Morning - as per the agenda. This includes speakers, activities, meals, etc. Delegates are responsible for all transportation to and from the conference site, as well as all personal spending money. PLEASE MAKE ALL CHEQUES PAYABLE TO ‘TADD NB’ Student Delegate Rates (Conference & Accom.) Adult Advisor Delegate Rates (Conference & Accom.) Single Occupancy - $325.00 Double Occupancy - $275.00 Single Occupancy - $325.00 Double Occupancy - $275.00 THESE RATES ARE PER PERSON THERE IS NO CONFERENCE FEE WITHOUT ACCOMMODATIONS EXCEPT FOR DELEGATES LIVING IN THE CITY OF FREDERICTON. PLEASE CONTACT [email protected] FOR RATE DETAILS. ADULT ACCOMMODATIONS Adult Advisors are not placed with students unless the group specifically requests it. If you wish to be placed with your students, please indicate so on your registration form by noting “sharing with students”. We do not place adult advisors in with students to fill space, and we therefore request that you select your advisor accommodations accordingly. We will accommodate advisors travelling alone with a request to place them into a double occupancy room with another advisor of the same sex, with each having their own bed. We will work diligently to place contingent delegates’ rooms in close proximity to their adult advisors. CANCELLATION POLICY If, for any reason, you cancel your registration before the April 24th, 2015 registration deadline, your delegate fees will be reimbursed less a $50 administration fee. There will be NO REFUND for cancellations after April 24th – as all rooms and meal counts will have been guaranteed. To avoid delays in the processing of your application form, please be sure that everything that the CYAID registration team requires is enclosed with your full payment. Please use the checklist below to be sure the registration package you are sending in for CYAID 2015 includes the following paperwork. Please be sure that all delegates’ names are spelled correctly as they will be used for all nametags, etc. THINGS I NEED TO SEND DONE Completed information page and Informed Consent for every delegate that is a minor Completed information page for every advisor Complete rooming list - including names of all delegates and advisors Full payment for every delegate (student and advisor) based on PER PERSON rates All contact information for my delegates’ group (including day and evening phone numbers) YOUR REMINDER NOTES OR QUESTIONS FOR CYAID COMMITTEE: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ On the following pages, please fill in your Group / Delegate information on the “Group Information Page”. The following table is a ‘sample’ of the information that is required on that page. COMPLETE First and Last Name of Every Delegate Advisor (A) or Grade of Delegate Male or Female Room Type (S, D,) Room Rate Based Upon Type Requested Room Number Smith, John 11 M D $275 1 Krause, Billy 11 M D $275 1 George, Randy 10 M D $275 2 John, Johnathon 10 M D $275 2 Jacobs, Nancy 12 F D $275 3 Weller, Becky 11 F D $275 3 Anderson, Jamie-Lynn A F S $325 4 CYAID 2015 REGISTRATION PAGE This page is to be submitted. FULL NAME OF YOUR GROUP GROUP’S HOME PROVINCE/TERRITORY NAME OF ATTENDING PRIMARY ADULT ADVISOR PRIMARY ADVISOR CONTACT (Days) PHONE # (Please include area code) (Evenings) ( ) ( ) PRIMARY ADVISOR EMAIL PRIMARY ADVISOR MAILING ADDRESS TOTAL NUMBER OF DELEGATES ATTENDING (INCLUDING ADULT ADVISORS) AMOUNT OF PAYMENT ENCLOSED A reminder of the conference fees … per person rates Student Delegate Rates (Conference & Accom.) Single Occupancy - $325.00 Double Occupancy - $275.00 Adult Advisor Delegate Rates (Conference & Accom.) Single Occupancy - $325.00 Double Occupancy - $275.00 GROUP INFORMATION This page is to be submitted COMPLETE First and Last Name Of Every Delegate Advisor (A) Or Grade of Delegate Male or Female Room Type (S, D, T, Q) Room Rate Based Upon Type Requested Room Number If you require additional space as you have a large group of delegates, please add an additional copy of this page and submit all additional delegates on the second page. DELEGATE INFORMATION (This must be completed by EACH delegate and sent in with your registration) LAST NAME ________________________________FIRST NAME ________________________________ Age __________ Grade __________ OR STUDENT ( ) NOTE: All delegates under 18 years of age must also submit an ‘Informed Consent’ with their registration form. The Informed Consent Form appears on the next page. ADULT ( ) Your Group’s Name (IN FULL) ____________________________________________________________ Name of Adult Advisor: _________________________________________________________________ Your Home Address: ____________________________________________________________________ City/Town __________________________ Province ________________ Postal Code: _______________ Email Address: ________________________________________________________________________ Home Telephone: ( ) _________________________ Cell Phone: ( ) ______________________ Emergency Contact Name: _______________________________________________________________ Emergency Telephone #: ( ) ____________________________ Doctor’s Name: ____________________________ Doctor’s Telephone #: ( ) ___________________ Specify any medical conditions that we should be aware of (i.e. Asthma, Epilepsy, Allergies, Etc.) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ FOR ADULT ADVISORS: Would you like to be a presenter at any of the adult advisor sessions? ___________________ INFORMED CONSENT FOR A MINOR TO PARTICIPATE IN CYAID 2015 I, the undersigned, understand and acknowledge that participation of my Child, _________________________________ in the Canadian Youth Against Impaired Driving National Conference (CYAID) in Fredericton, New Brunswick from May 21st to May 23rd, 2015 (“the Event”) might result in personal injury, property damage or loss, and possible death. I also understand that the travel associated with the Event also adds additional risk. I fully understand these risks and hereby agree to have my Child participate in the Event voluntarily and at his or her own risk. I warrant that my Child is physically, mentally and emotionally fit to participate in the Event. I understand, agree and acknowledge that by choosing to have my Child participate in the Event brings with it the assumption by me and by my Child of the risks and I assume full responsibility to instruct my Child about the risks and the choices available to him or her relative to those risks. I shall indemnify and save harmless the Teens Against Drinking and Driving Association of New Brunswick (2015 CYAID Conference Hosts), all of its employees, officials, officers and authorized representatives from and against all suits, actions, legal or administrative proceedings, claims, demands, damages, liabilities, interest, legal fees, costs and expenses of whatsoever kind or nature in any manner directly or indirectly caused by any act of my Child in connection with or incidental to my Child’s participation in the Event. I, as the parent/guardian of said Child, declare that I have read, understood and agree to the contents of the Informed Consent from in its entirety. Dated this _____________ day of __________________________________, 2015. Parent / Guardian Printed Name _______________________________________________________________________ Parent / Guardian Signature __________________________________________________________________________ Witness Printed Name _______________________________________________________________________________ Witness Signature ___________________________________________________________________________________ Delegate’s Group Name ______________________________________________________________________________
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