If you experience technical difficulties when using this form or if you have registration questions, please contact
General Surgery Review Program at:
Section A - Delegate Information
Section B - Delegate Registration
Registration fees include all programming from Monday, February 22 to Friday, February 26, 2021. Session video
recordings will be made available
to attendees after the program for a limited time. All amounts are in Canadian dollars. No session selection is
There is no option to purchase one-day passes.
Please select a registration type.
Section C - Payment Information
Please verify all the information is correct. By submitting your payment, your credit card statement
will show this transaction as General Surgery Review Program.
Cancellation Policy - All cancellations must be received in writing no later than February
5, 2021 for a full refund, less an administrative fee of $200.00. No refunds will be issued after this
date. We will not be able to issue refunds due to technical issues experienced due to a poor internet connection
or your equipment not meeting the technical requirements.
Section D - Participant Consent & Release Agreement
(Please scroll to the end and click on I AGREE checkbox after reading.)
CONSENT TO BE VIDEO RECORDED, AUDIO RECORDED, PHOTOGRAPHED, RECORDED AND/OR TO HAVE PUBLIC DISCLOSURE OF
INFORMATION, AND WAIVER OF CONFIDENTIALITY FOR MEDIA PURPOSES.
I hereby give my permission and express written consent to General Surgery Review Program (referred to
herein as “GSRP”) to digitally video record, videotape, digitally audio record and/or photograph me
while I am attending and participating in the GSRP. I further consent to GSRP and its agents
and assigns exhibiting, showing, re-producing, publishing, displaying, transmitting and other uses of all
such video and audio recordings and photographic images in any media whatsoever in Canada or elsewhere,
including presentations made for medical, scientific, educational and related marketing purposes.
I further acknowledge, confirm and agree that I shall have no right to inspect or approve any video and audio
recordings and/or photograph(s) of me prior to it or their use by GSRP or its agents and assigns in
any manner and confirm and agree that I will receive no financial compensation arising from such use,
including, without limitation, my providing services as a model.
I hereby fully and finally release GSRP and its agents and assigns from any and all liability directly
or indirectly arising out of the video and audio recordings and photographic images made and/or taken of me
including, without limitation, how such recordings and images are used by GSRP and its agents and
assigns, the final form of such recordings and photographs and the timing, method and basis of it or their
publication and distribution.
I acknowledge that GSRP and its agents and assigns shall have the right to cancel or convert to a
virtual event any event offered or organized by GSRP or its agents and assigns for which I may
register to attend up to and including the day immediately prior to the scheduled commencement date of such
event by email notification to me at the last email address I have electronically delivered to GSRP
or its agents and assigns. I hereby further release GSRP and its agents and assigns from any and all
claims relating directly or indirectly to such cancellation that I or my heirs, executors and administrators
may have and hereby confirm and agree that GSRP and its agents and assigns shall at no time be liable
to me or my heirs, executors and administrators for any direct or consequential losses, damages, expenses or
costs which I may suffer or incur as a result of a cancellation, including, without limitation, unnecessary
travel expenses and loss of income.
WAIVER OF LIABILITY AND ASSUMPTION OF RISK ACKNOWLEDGEMENT
In consideration of GSRP or its agents and assigns permitting me to participate in any capacity
whatsoever in the GSRP (including but not limited to participation as an attendee or speaker), I
hereby agree to the following terms:
- I expressly warrant and represent that by attending the GSRP I am knowingly, freely and
irrevocably assuming all risk while participating in and or attending the GSRP, in any manner
whatsoever, regardless of how, where or when I may incur or sustain any injury, damage or loss, and
whether or not resulting from the negligence of GSRP and its agents and assigns or otherwise.
- None of GSRP or its directors, officers, employees, agents or assigns (the “Releasees”) shall be
liable nor held responsible in law by me, or my heirs, executors, assigns and any legal or personal
representatives for any physical bodily injury (including, without limitation, loss of life or limb, and
contracting any communicable disease or virus), damage or other loss (including but not limited to
economic loss) incurred by me, however sustained or incurred at any time during my participation or
attendance at the GSRP, including my travel time to and from the GSRP.
- I hereby irrevocably release and hold the Releasees harmless in respect of any and all liability for and
in respect of my physical injuries (including, without limitation, loss of life or limb, and contracting
any communicable disease or virus),, and/or economic loss derived from my participation and involvement,
in any manner, in the GSRP.
- Once I have agreed to this Participant Consent and Release Agreement, it will constitute a full answer
and defence in favour of the Releasees in relation to any claim that I may advance against same for any
physical injury (including, without limitation, loss of life or limb, and contracting any communicable
disease, virus), damage or loss sustained by me while participating in or attending the GSRP.
- I understand that it is a condition of my participation in the GSRP that I must agree to the
terms of this Participant Consent & Release Agreement and that I am under no requirement or compulsion
to participate or attend the GSRP and I am free to decline participation if these terms are not
acceptable to me.
- While attending the GSRP I agree to abide by all rules posted or otherwise provided to me, as
well as all applicable federal, provincial and municipal laws and regulations.
- I agree that regardless of actual causation, I am solely responsible for my safety while participating
and attending the GSRP.
- I understand that this is an exam preparation course and that GSRP is not liable for my
individual test results and/or failure of any professional exam as a result of participating in this
- I shall not disclose, share, distribute or reproduce any course material or any provided passwords I
receive from the GSRP to any third party and acknowledge and agree that any breach whatsoever
will result in no longer having access to all materials provided.
I have read the foregoing Participant Consent & Release Agreement and confirm and agree that I fully
understand its contents. I hereby warrant that I am of legal age and am competent to contract. I hereby
provide and deliver both my express and informed consent as stated above and my agreement with the terms as
outlined above by clicking on the I AGREE button/box as presented on this website and confirm that this
Participant Consent & Release Agreement when given in this manner shall be forever binding upon me.