Registration Type(Required) Early Bird Member ($495.00) - Expires June 15th Early Bird Non-Member ($575.00) - Expires June 15th Member ($545.00) Non-Member ($595.00) Billing InformationName(Required) First Last Suffix Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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Phone(Required)Attendee Address Attendee Address Same as Billing Address Attendee Address Details(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How do you wish to have your name appear on your attendee badge?(Required) Include first name or nickname, last name, degrees and certifications (if desired).Is this your first time attending? Yes No Pick which best describes your role Veterinarian Veterinary student Veterinary Technician/Nurse Veterinary Technician/Nurse Student Other Veterinary Staff (Assistant, receptionist, etc) Professional Animal Trainer Other Are you a member of: [select all that apply] SVBT AVSAB AVBT None Meal Preference: [select all that apply] No dietary preference Vegetarian Vegan Gluten Free Please share how you learned about our conference: [select all that apply] Social Media Trade Publication Colleague/Friend School Previous Attendee Trade Conference Professional Association Other For RACE credit, add your license number and licensing state here: For CCPDT credit, add your CCPDT number here: Licensing State Cancellation Policy(Required) I agree to the Cancellation Policy.REFUND POLICY: A FULL REGISTRATION FEE REFUND, MINUS A $50 PROCESSING FEE, will be made if cancellation notice is received in writing to [email protected] by Sept 1, 2022. No refunds will be made after Sept. 1, 2022. No refunds will be made due to inclement weather. The refund will be made through the PayPal system to the account or Credit Card used for the registration payment. Please allow several weeks for the refund to process to complete. Additional fees may be charged by Paypal and are not under the control of the Clinical Animal Behavior Conference. Contact [email protected] regarding refund questions.Liability Waiver(Required) I agree to the Liability Waiver.WAIVER OF LIABILITY: I understand and acknowledge that my voluntary travel to and participation in the Clinical Animal Behavior Conference (CABC), including transportation provided by the CABC to the Viticus Center, the facilities, presenters, and animals used in hands on labs, involves an inherent risk of and exposure to property damage and bodily or personal injury or death to myself or to others. I understand and acknowledge that I am solely responsible, through insurance or otherwise, for any hospital or other costs arising out of any bodily injury or property damage sustained through my participation in CABC. I hereby assume any and all such risk. In consideration for CABC permitting me to participate in the CABC, I hereby waive liability, release, hold harmless, covenant not to sue, and forever discharge Releasees from any and all liability, claims, demands, rights, and causes of action of whatever kind, arising from or by reason of any personal injury or death, property damage, or the consequences thereof, whether caused by the negligence or carelessness of the Releasees or otherwise resulting from or in any way connected with my participation in and travel to and from the Conference. I understand that acceptance of this signed Waiver of Liability constitutes an agreement not to sue the Releasees; that it shall be effective during the entire period of my participation in CABC; that it binds me and my heirs, executors, administrators, and assigns; that it shall be construed in accordance with the laws of Nevada; and that if any of its terms or provisions are held illegal, unenforceable, or in conflict with any law, the validity of the remaining portions shall not be affected thereby.Photo/Media Release(Required) I agree to Photo/Media Release.PHOTO AND MEDIA RELEASE: I hereby grant CABC the rights of my image, likeness and sound of my voice as recorded on any audio or visual media in connection with the above-identified event. I authorize CABC, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that CABC may use my image, likeness and sound of my voice as recorded on audio or visual media for any lawful purpose, including for example such purposes as publicity, illustration, advertising and Web content. I acknowledge that I fully understand the above release; agree to be bound thereby; and hereby release any and all claims against CABC when utilizing my image, likeness and/or sound of my voice as recorded on audio or visual media.COVID-19 & Illness Statement(Required) I agree to follow current national and regional safety guidelines, as well as, the guidelines set by Viticus Center while attending the 2022 Clinical Animal Behavior Conference.The Clinical Animal Behavior Conference is committed to the safety of all participating in this year’s conference. We will be following current national and regional safety guidelines during the COVID-19 pandemic. Please note that attendance at any public event increases the risk of contracting COVID-19 or other airborne illness. Attendees assume all risk associated with attendance. Any attendees who feel ill, regardless of their symptoms, should not attend this event. Δ