Conference Registration
Name(s) Please list the ages of any children attending

*

   
Address
City
Province/State
Postal/Zip Code
Country
Email*
Home Phone
Cell Phone
   

I am a student and/or under 18 years of age
 Registration is FREE (you can ignore Paypal payment process after clicking on the "submit" button below)

I am a physician/medical professional attending the CME Session
 $79 registration fee is required

I am a member of the CMA
 $65.00 registration fee is required (1 adult)
$130.00 registration fee is required (2 adults)

I am not a member of the CMA
 $85.00 registration fee is required (1 adult)
$170.00 registration fee is required (2 adults)

2 Adults (1 member and 1 non-member)
 $150.00 registration fee is required

I would like to become a member of the CMA
Individual $25.00
Family $35.00
I would like to make a tax credible donation of $
 
Total Amount


*Registration is limited. Registrations and payment must be submitted by June 19, 2009 (No Exceptions). No Babysitting service available.

*Cancellation Policy: There will be a $25 administration fee for any conference cancellations. No refunds after June 19/09.

Thank You For Your Support

 

Resize Website Text

First Name
Last Name
Email