2022 MEMBER SPRING CLINIC REGISTRATION

PERSONAL INFORMATION

Last Name

First Name

Street Address

Date

City

State

Cell Phone

Zip

E-Mail Address

Please select your shirt size (tech shirt) for the giveaway.

We apologize, but the window for receiving a shirt has passed,

due to an ordering deadline imposed by the supplier.

YOU CAN STILL REGISTER FOR THE CLINIC!

When you click the Register Now button, you will be taken to the payment page.

After you make your payment, you will be registered for the Spring Clinic.

Your payment is non-refundable.

Thank you for submitting your payment. We look forward to seeing you at the clinic!

2022 SPRING CLINIC REGISTRATION