2025 Florida Chapter Annual Meeting Registration

Contact Information

Name

First NameLast NameSuffix

Degree

ACS Member ID

Required for myCME Dashboard

Specialty:

Medical License Number:

Practice Type:

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Email:

example@example.com

Organization:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Pre-Event Emergency Contact

Onsite Emergency Contact

Hold Harmless Waiver

Travel to and attending in person meetings entails the risk of contracting communicable diseases; I agree to waive and hold the FCACS, the American College of Surgeons, the facility, and each of their agents harmless from and against any liability, damages or expenses arising from travel to or attendance at the event; I agree to follow all health and safety protocols announced by the FCACS, the facility, and governmental authorities.

Choose your registration(s)

Florida Chapter and South Florida Chapter Members

$225.00

Non-Member

$275.00

Resident/Fellows-in-Training

$100.00

Medical Students

$65.00

Enter coupon

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Do you plan to attend the Welcome Reception on Saturday, May 3, 2025 at 6:00 pm (immediately following sessions)?

Choose your registration(s)*

Choose your registration(s)