Registration

"*" indicates required fields

Registrant Information

Attendee's Name*

First Name Last Name

Email Address*

Phone Number*

Select Your Registration Category:*

Member Junior Physician (One Day) ($125)

Member Junior Physician (Two Days) ($175)

Member Senior Physician (One Day) ($200)

Member Senior Physician (Two Days) ($250)

Non-member Junior Physician (One Day) ($200)

Non-member Junior Physician (Two Days) ($250)

Non-member Senior Physician (One Day) ($325)

Non-member Senior Physician (Two Days) ($375)

Allied Health (One Day) ($75)

Allied Health (Two Days) ($125)

Presenter

Moderator

Special Registration

Name of Company or Organization for Special Registration*

Please note that this option is only available for pre-approved companies, groups or organizations. Any registration that uses this option without prior approval, will have to pay the standard rate upon check-in.

Sunset Cruise Tickets Quantity

Price: $60.00

Quantity

Late Registration

Price:

Payment Information

Credit Card*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Total

Review Your Registration

{all_fields} The totals displayed above are in Bahamian Dollars (BSD)

Unique ID

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