Register for the 2010 Seattle Study Club Symposium

Non-Clinical Programs

• Non-Clinical Registration
  • On or before October 15, 2009 $1,795
  • After October 15, 2009 $1,945
• Meals & Entertainment Only
  • On or before October 15, 2009 $1,395
  • After October 15, 2009 $1,545

Personal Information

• Name:
• Select One: Spouse/Partner Staff Guest Coordinator Other
• Club Name:
• Address:
• City:
• State / Province:
• Zip:
• Home:
• Work:
• Cell:
• Fax:
• Email:
• Jacket Size: Male Small Medium Large X-Large XX-Large
    Female Small Medium Large X-Large
• Dietary Restrictions:
• Travel Arrangements: Staying at The Phoenician Resort
  Other, please specify

Monday Breakout Sessions

Please choose the guided hike, or place the clinical breakout sessions in order of preference (1 is who you would like to see most, 6 is the least). Registrants will be assigned to two breakout sessions based on space availablility.

• McDowell-Sonoran Preserve Hike
• 
  OR
  
  
• 1 2 3 4 5 6 Dr. Michael Fling
• 1 2 3 4 5 6 Dr. Bob Margeas
• 1 2 3 4 5 6 Dr. Harold Menchel
• 1 2 3 4 5 6 Dr. J. William Robbins
• 1 2 3 4 5 6 Dr. Jeffery S. Rouse
• 1 2 3 4 5 6 Dr. Marcos Vargas

Wednesday Breakouts

• Self-defense Workshop
• Speaker Showcase

Children

(Ages 7 - 12) @$495 each.

• Name:
• Age:
• Name:
• Age:

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