Alternate Payment

Participant Information
Name (As it is in your passport)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
[email protected]
Phone Number

Country CodeArea CodePhone Number
Do you require visa to Canada?*

YesNo
Passport # (If visa letter is needed)
Passport Issuing Country
Date of Birth
MM/DD/YYYY
Upload Passport Copy

Only upload your passport biodata page
Cancelof
Referred by
How did you hear about WODIL*
Disability

I am disabled and will need event access assistance
What are your disability needs
Any food requirements?*

VeganVegetarianGluten FreeNone
Accompanying person (0-11 years old)
Children between 0-11 years old
No. of Accompanying Person(s)

OneTwo
Name

First NameLast Name
Date of Birth
mm/dd/yyyy
Name

First NameLast Name
Date of Birth
mm/dd/yyyy
WODIL Terms and Conditions*

My Products

Full Registration

Full 4 Days Registration Product Image

Full 4 Days Registration Full 4 days in-person registration

$950.00CAD No. of Persons
Item subtotal:$0.00CAD

Accompanying person

Accompanying person Product Image

Accompanying personChildren between 0-11 years old

$200.00CAD No. of Persons
Item subtotal:$0.00CAD

Enter coupon

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: