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NEW FOR 2023 - ALL CAMPS START AT 1:00 PM ON FRIDAY (previously 3PM)

Individual Registration

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First Name *

Last Name *

Billing Address *

Billing City *

Billing State *

Billing Zip *

Practice City *

Practice State *

Mobile Phone *

Email *

Title *

Doctor's Last Name *

Room Reservation Reminder *

You must make your own room reservations for this event. Please check to acknowledge you have read this notice.

Would you like to make a donation to sponsor other DCs to attend events? *

No, thank you

$100

Cancellation Policy *

There will be a $100 per person administrative fee if registration is cancelled up to 14 days prior to the event. Cancellation within 14 days of the event incurs a 50% per person fee. Please check to acknowledge you have read this notice.

Whom can we thank for referring you to TLC?

Payment Information

Coupon Code

Amount

Discount

Amount Due

Deposit Amount

Payment Type

Payment Method

Authorize.net

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

By registering for this event, I accept Terms and Conditions

Verification code*

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Individual Registration

Payment Information