2017 Joint Meeting Registration


WASHINGTON STATE DERMATOLOGY ASSOCIATION and
OREGON DERMATOLOGY SOCIETY
2017 Joint Dermatology Meeting
August 11-13, 2017
Sunriver Resort
Sunriver, OR

Contact Information

Name:*
Title:
Preferred First Name for Badge:
Group Name:
Address:
Phone:
-
E-mail:*

(Email address is required to receive a confirmation/receipt and your e-syllabus)

Conference registration fee includes your three-day conference tuition, e-syllabus, opening night reception, as well as all breakfasts and refreshment breaks. The Saturday Night Dinner Banquet is free for the attendees and their guests.

Conference Registration

Registration Type:

Saturday Dinner Banquet

I will be attending the Saturday dinner (included with registration):
No. of adult dinner guests:
No. of child (under 12 years) dinner guests:

Optional Events

We’re offering golf ($160) and kayaking ($85) Saturday from 12:00-5:00pm.  Lunch is included for both events.

Golf - Number attending (including self):
Kayaking - Number attending (including self):

Payment

Total:
Please verify:

Upon completing the form and clicking "submit," if any funds are due to complete the registration, you will be directed to PayPal to make the payment.

CANCELLATION POLICY: We must receive written notification of your cancellation. A $50 processing fee will be deducted from the registration refund. No refunds will be issued after August 1, 2017.

INQUIRIES: Contact the WSDA Office at 206-956-3635, or call toll free from Washington, 1-800-552-0612, ext. 3018, or send emails to admin@washingtonderm.org.