Alzheimer Society of Toronto

Only 1 email address per registration, you could then share your screen with your guest(s). Please do not forward the Zoom link.

We still have room for 17 guests at this event.
The reservation limit per user is 2 guests.

* First Name

* Last Name

* Email

Yes, I would like to receive periodic updates and communications.

* Phone

Please specify the number of guests, including yourself, that will attend:

Please answer the following additional questions:

*1.	Question - Required - Help us serve you better, please identify if the participant attending the program identifies as a:
2.	Question - Not Required - Name(s) of participant(s) attending the program: (Maximum response 255 chars, approx. 5 rows of text)
*3.	Question - Required - What is your Date of Birth? (dd/mm/yyyy) (Maximum response 255 chars, approx. 5 rows of text)
4.	Question - Not Required - Can you please type in your preferred pronouns? (If you prefer not to disclose, please write "Prefer not to answer") (Maximum response 255 chars, approx. 5 rows of text)

Would you like to receive an email reminder for this event?

Yes, email me a reminder