Registration - Northern Sierra Conservation & Wilderness Medicine Conference

Registration Form

June 4 - 5, 2022
Quincy, California

Registrations are now closed for the 2022 Sierra Nevada Conservation and Wilderness Medicine conference. We look forward to seeing you in 2023!

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First Name ^*

Please confirm your First Name

Last Name ^*

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Email Address ^*

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Home Phone

Cell Phone ^*

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Billing Address ^*

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City ^*

Please confirm your City

State ^*

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Zip Code ^*

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Country

Special Dietary Needs

None

Vegetarian

Other

Other Dietary Needs

Company/School

Medical Specialty (if applicable)

Other Related Affiliations (i.e. organizations, associations, universities, etc.)

Outdoor Interests (i.e. hiking, skiing, mountain biking, etc.)

If you are bringing children ages 12 and under, how many are you planning to bring?

Cancellation Policy Agreement

Please Read Cancellation Policy Before Agreeing.*

Cancellation Policy: Cancellations received in writing more than four weeks prior to event will receive a full refund. Cancellations received in writing two-four weeks prior will receive a refund less a $100.00 administrative fee. There will be no refunds for cancellations received within two weeks of the event.

Please remember that canceling your registration does not automatically cancel your hotel and travel arrangements. Individuals are responsible for canceling their own hotel and travel reservations.

I have read and agree to the terms above. ^*