Annual Meeting Guest Registration "*" indicates required fields Step 1 of 2 - Contact Information 50% Today's Date September 25-27, 2026 Suncadia Resort and Spa Cle Elum, WA https://www.destinationhotels.com/suncadia-resortContact InformationName* First Last Credentials (MD, DO, PhD, etc.) Billing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Registration & Payment InformationNo. of adult dinner guests:Adult dinner guests are $100.00 eachSelect # of adult dinner guestsOne guest - $100.00 - $100.00Two guests - $200.00 - $200.00Three guests - $300.00 - $300.00Four guests - $400.00 - $400.00No. of child dinner guestsChildren ages 5-12 are $35 each; children under 5 years old are free.Select # of child dinner guests 5-12 years oldOne child guest - $35.00 - $35.00Two child guests - $70.00 - $70.00Three child guests - $105.00 - $105.00Four child guests - $140.00 - $140.00No. of child dinner guests under 5 years.Children ages 0-5 are free.Select # of child dinner guests under 5 years oldOne child guest - $0.00Two child guests - $0.00Three child guests - $0.00Four child guests - $0.00Coupon TOTAL Payment Type* Credit Card Check Check Number*CREDIT CARD* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name CANCELLATION POLICY: We must receive written notification of your cancellation. A $75 processing fee will be deducted from the registration refund. No refunds after August 28, 2026. INQUIRIES: Contact the WSDA Office at (425) 470-3843 or send emails to washingtonderm.org. Δ
