Virginia Beach, VA Conference Registration Form

August 11-14, 2020

Registration badges will be required for admission to all events. Payment is due with registration form and must be submitted according to the above dates 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 with your browser and fax or mail to Skin, Bones, Hearts & Private Parts.

In accordance with the Americas with Disabilities Act, please notify the Skin, Bones, Hearts & Private Parts office if you have any special needs.

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.

REFUNDS:

Written notice of cancellation must be received by July 11th, 2020. 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:
770-640-1095

Make checks payable to DMGCME:
DMG’s Federal Tax ID#: 58-2582200

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