2026 WSPMA Annual Conference Attendee / Speaker Registration Form Step 1 of 5 20% EmailThis field is for validation purposes and should be left unchanged.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 RicaCroatiaCubaCuraƧaoCyprusCzechiaCĆ“te 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 FederationRwandaRĆ©unionSaint BarthĆ©lemySaint 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 IslandsTuvaluTĆ¼rkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweĆ land 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 To Register, please select an option from the dropdown for either Registration WSPMA Member or NON-WSPMA Member.Registration WSPMA Member*Designates early bird pricing which ends on 6/30/26Select OneEarly Bird $350* (After 6/5/2026 price goes up to $400)1st & 2nd Year Associate $250Senior MemberLifetime Member $100Non-Practicing Member $100WA Resident/Fellow FREEWSPMA Board of Trustee FREEWSPMA Volunteer / Contractor FREERegistration NON-WSPMA Member*Designates early bird pricing which ends on 6/30/26Select OneEarly Bird $450* (after 6/5/2026 price goes up to $500)1st & 2nd Year Associate $250WA Resident/Fellow FREEOther 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 Photo ReleasePhoto Release Permission I grant permission to WSPMA and the Wenatchee Convention Center to photograph me and to use such media for promotional or educational purposes. Hotel RegistrationWSPMA has secured a limited room block at the Coast Wenatchee Center Hotel for the duration of the Annual Conference. The discounted rate is $136 per night (plus applicable taxes). The hotel is connected to the Wenatchee Convention Center by a covered skybridge and offers free parking and a complimentary continental breakfast for all guests. Booking Your Room All attendees are responsible for booking their own hotel stay using the Coast Wenatchee Center Hotel Booking Link. ā¢ A limited number of rooms are available at the $136/night rate ā early reservations are strongly encouraged. ā¢ Room rates do not include state, local, or occupancy taxes. ā¢ Reservations may be canceled up to 48 hours prior to arrival; cancellations after that time may incur charges. ā¢ The reservation deadline for the WSPMA room block is August 25, 2026. ā¢ Guests are responsible for all hotel charges and fees. Will you be booking a hotel reservation at the Coast Wenatchee Center Hotel:*(Required)Please indicate whether you plan to book a room at the Coast Wenatchee Center Hotel. Selecting āyesā does not guarantee a room or the discounted rate; you must complete your reservation directly through the hotel link. Yes, I will be booking a hotel reservation at the Coast Wenatchee Center Hotel No, I will not be booking a hotel reservation I do not know Book Now Coast Wenatchee Center Hotel Booking Link Social Hour RegistrationThere will be a Social Hour Reception on Friday, September 11, 2026, from 5:45 ā 7:00 PM. Conference attendees are FREE. Guests are $25/ticket. Will you be attending the Friday, September 11, 2026: Social Hour from 5:45 ā 7:00 PM.*(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 11, 2026: Social Hour from 5:45 ā 7:00 PM. 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, 2026. 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 ā 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 Upcoming Events WSPMA Annual ConferenceWSPMA Annual ConferenceDate Sep 11 - 13, 2026Time 4:00 pm - 12:00 pmVenue Wenatchee Convention CenterOrganizer WSPMAMore Info Washington & Oregon'sĀ Annual Complications Case Review SeminarWashington & Oregon'sĀ Annual Complications Case Review SeminarDate November 7, 2026Time All Day EventVenue Swedish Medical Center: Cherry Hill Campus – James TowerOrganizer WSPMAMore Info Our Corporate Sponsor
WSPMA Annual ConferenceWSPMA Annual ConferenceDate Sep 11 - 13, 2026Time 4:00 pm - 12:00 pmVenue Wenatchee Convention CenterOrganizer WSPMAMore Info
Washington & Oregon'sĀ Annual Complications Case Review SeminarWashington & Oregon'sĀ Annual Complications Case Review SeminarDate November 7, 2026Time All Day EventVenue Swedish Medical Center: Cherry Hill Campus – James TowerOrganizer WSPMAMore Info
