Refuge Tech Safety Summit

Registration Form

Please enter a professional email address when registering for this event. All registrations are subject to approval.

Step 1 – Personal information

First Name

Last Name

Job Title

Organisation

Phone Number

Password

Pronouns

Special requirements (i.e. access requirements)

Type of ticket

Preferred Date to Attend

Payment Method

Name of Contact

Company Name

Email Address

Full Company Address

Packages

Payment Section

Step 2 – Questions

What is your discipline?

Number of employees in your organisation:

How did you hear about the Tech Summit?

Step 3 - Acknowledgement

By registering for this event, I agree to receive emails from the Refuge regarding this event. Emails include, but are not limited to registration confirmation, modification and cancellations, event schedules, and communications related to continuing education.

I agree

I certify that all information provided on this registration is true and correct to the best of my knowledge.

I agree

By registering for this event, you agree you have read our privacy notice and agree to the terms and conditions.

I agree

We would love to keep you informed about future events. Please indicate below the communication you wish to receive. Refuge will not share your contact information.

I wish to be contacted by email:

I wish to sign up to the Refuge Tech Safety newsletter