Chicago, IL CME Conference Registration Form
August 30 – September 3, 2021
Registration badges will be required for admission to all events. Payment is due with the registration form and must be submitted according to the indicated dates (shown in step 2 of registration) to qualify for the corresponding rate. Materials can only be guaranteed to pre-registered attendees – be sure to register early.
Please complete and submit the registration form below. One registration form per person. If you prefer, you may print this form using the button below and either fax or mail to Skin, Bones, Hearts & Private Parts.
Written notice of cancellation must be received by July 31, 2021. A $75 administrative fee will be retained. For a detailed look at the refund policy, please click here.
MAIL OR FAX INSTRUCTIONS:
If paying by credit card, please be sure to include all credit card information, including credit card number and billing zip code.
Payment is due with registration form and must be postmarked/submitted by the above dates to qualify for corresponding rate. To avoid duplicate charges, do not mail original registration form if you have already faxed it or submitted it via this webform.
In accordance with the Americans With Disabilities Act, please notify the Skin, Bones, Hearts & Private Parts office if you have any special needs.
Complete form and mail to:
Skin, Bones, Hearts & Private Parts
1905 Woodstock Road, Suite 2150
Roswell, GA 30075
Complete form and fax to:
Make checks payable to DMGCME:
DMG’s Federal Tax ID#: 58-2582200
SBHPP will take photos of attendees throughout the conference. These photos are for SBHPP use only and may appear on the SkinBonesCME.com, news updates, conference brochures, social media outlets, or other future SBHPP promotional material. By virtue of your attendance, you agree to usage of your likeness in such media.
By registering for this event, you are giving permission for Skin, Bones, Hearts & Private Parts to share your name, credentials, and email with our sponsors.
AMERICANS WITH DISABILITIES ACT:
In accordance with the Americans with Disabilities Act, please notify the Skin, Bones, Hearts & Private Parts office if you have any special needs.