Tahoe Forest Health System

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ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Winter Illness and Injury Symposium 2022
Monday, December 5, 2022

3:00pm - 9:00pm

Tahoe Forest Health System invites you to attend the Winter Sports Illness and Injury Symposium on December 5, 2022 at the Hyatt Regency Lake Tahoe Resort, Spa and Casino. Please fill out the registration form thoroughly as there are multiple items that request your feedback. Registration deadline is November 30, 2022. Space is limited.

Conference Registration

Conference Participant Rate

$25.00

Rate includes registration, dinner, door prize and raffle ticket.

Total: $0.00

Attendee Information

I am a:
(Please check all that apply.)

Firefighter:

Ski Patroller:

EMS Agency:

Law Enforcement:

Hospital Staff:

Medical Clinic:

Other:

Please select Level of Training: *

First Name: *

Last Name: *

Organization: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

Cell Phone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *