2025 WSPMA Annual Conference Registration Form Step 1 of 5 20% RegistrationWho are you registering? Register Yourself Register Guest Contact DetailsName(Required) Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Middle Last Name Badge(Required)Please enter your first name as you would like it to appear on your name badgeIn what city do you practice?(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone(Required)Email(Required) Select work or home option belowIs email Home or Work(Required) Home Work I am currently registering as a(Required)When selecting "Other", please enter Job Title DPM Resident Fellow Guest Assistant Speaker WSPMA BOT Other Registration(Required)*Designates early bird pricing which ends on 8/8/25 WSPMA member - $350* WSPMA member - After 8/8/2025 $400 WSPMA member - First Year Practicing $250 WSPMA Lifetime Member $100 WSPMA Members Assistant $100 WSPMA Board of Trustee: FREE Resident/Fellow in WA - FREE Non-member - $450* Non-member - After 8/8/2025 $500 Non-members Assistant $150 Other: When paying, please enter code that you have received from WSPMA Conference Attendee RosterPlease allow us to include you on the conference attendee roster (containing conference attendee names, titles, organizations, and email addresses), which will be available to conference attendees, as well as conference sponsors. By sharing your information in the roster, you will be able to: Connect with other conference attendees Easily share your contact information with new colleagues Receive relevant product and service information from conference sponsors supporting this event* *Sponsors have limited access to the attendee roster and may only use it to send two emails. If attendees are contacted by sponsors after the event, they always have the option to opt out of any promotional materials. Roster Inclusion Please include my contact information on the conference attendee roster Do NOT include my contact information on the conference attendee roster Hotel RegistrationWSPMA has reserved a room block with a $131/night room rate plus taxes at the Coast Wenatchee Center Hotel for the duration of the Conference. The hotel is connected to the Wenatchee Convention Center by a covered skybridge and offers FREE parking to all hotel guests. A complimentary continental breakfast is also available for hotel guests. Please check whether you will/or will not be booking a room(s) on this registration page. Then to book a room for the conference click this Coast Wenatchee Hotel Booking Link and follow the instructions to book your room directly with the Coast Wenatchee Center Hotel. This link is also located on the main 2025 WSPMA Annual Conference Page. • All room rates are quoted exclusive of applicable state, local and occupancy taxes. • You can cancellation your reservation 48hrs in advance. After that you are responsible for any charges/fees. • If you are a no show, you are responsible for your room reservation cost, not WSPMA. • Reservations are due by August 25, 2025. • All guests are responsible for all hotel charges, fees, room service. Will you be booking a hotel reservation at the Coast Wenatchee Center Hotel:*(Required) Yes, I will be booking a hotel reservation under WSPMA room block No, I do not need a hotel reservation I do not know Book a room for the conference Coast Wenatchee Hotel Booking Link and follow the instructions to book your room directly with the Coast Wenatchee Center Hotel. Social Hour RegistrationThere will be a Social Hour Reception on Friday, September 12, 2025: Social Hour from 5:30 – 6:30pm. Conference attendees are FREE. Guests are $25/ticket. Will you be attending the Friday, September 12, 2025: Social Hour from 5:30 – 6:30pm.*(Required) Yes, I will attend No, I will not attend I am not sure Would you like to bring a guest with you to the Friday, September 12, 2025: Social Hour from 5:30 – 6:30pm. Guest tickets are $25/ticket*(Required) Yes, I would like to buy a guest ticket No, thank you I am not sure Dietary Restrictions and Additional ServicesPlease let us know if you have any dietary restrictions, mobility limitations, or other special accommodation needs. WSPMA will do its best to accommodate dietary restrictions, but we cannot guarantee that all special diets can be accommodated. Special Requests(Required)If choosing other (please list food allergies and/or other ADA request below). I require vegetarian meals I require vegan meals I require gluten-free meals I will be using a wheelchair I have no requests Other Cancellation PolicyConsent(Required)A $75.00 processing fee will be charged to any cancellation. Cancellations must be made in writing to info@wspma.org by August 12, 2025. No refunds for cancellations will be honored after this date. Substitute attendees will be permitted. No refunds can be made by WSPMA for lodging, airfare, or any other expenses related to attending the conference. Refunds are not granted to no-shows. I agree to the cancellation policy Donate to WSPMAPlease consider making a donation to the Erickson Scholarship Fund and/or WSPMA PODPAC.Established in 1993 in memory of a long-time member and former WSPMA President E.P. Erickson, DPM. The Erickson Scholarship Fund provides scholarships to students from the state of Washington. E.P. Erickson, DPM, became an APMA member in 1940 and passed away in 1991. Dr. Erickson was a long-time WSPMA member, served as president of WSPMA from 1964 – 1966, and was Treasurer for many years up until his death. He was also recognized as podiatric physician of the year in 1967. Erickson Scholarship DonationNone$50$75$100$150$250$500$1000OtherOther PODPAC is the Washington State Podiatry Action Committee fund. It is your local Political Action Committee. PODPAC funds help our lobbyists in Olympia gain better access to legislators who can influence state legislation affecting healthcare and our businesses as healthcare providers. Your donations help keep podiatric medicine from getting lost or undermined in the legislative shuffle at the state level. Your livelihood is affected by politics, and donations help podiatric physicians maintain influence in the political arena in Olympia. We are a small organization and every donation counts. WSPMA PODPAC DonationNone$50$75$100$150$250$500$1000OtherOther Payment DetailsHow Would You Like to Pay?(Required) Credit Card Check Zero Balance Processing FeesIf you are suppose to have a zero balance but see that you have a processing fee, please select Zero Balance from the "How Would You Like to Pay" option above to make sure it cancels the processing fees. Price: $0.00 Total CouponIf provided, please enter code that you have received from WSPMA. Please make check out to WSPMA. Include your Company Name and registration type on the check Mail check to WSPMAPO Box 3407 Edmonds, WA 98020 Credit Card Cardholder Name Card Details EmailThis field is for validation purposes and should be left unchanged. Upcoming Events WSPMA Annual Conference 2025WSPMA Annual Conference 2025Date Sep 12 - 14, 2025Time All Day EventVenue Wenatchee Convention CenterOrganizer WSPMAMore Info Our Corporate Sponsor
WSPMA Annual Conference 2025WSPMA Annual Conference 2025Date Sep 12 - 14, 2025Time All Day EventVenue Wenatchee Convention CenterOrganizer WSPMAMore Info
