2022 TORCH/TARHC Fall Conference & Trade Show

NOTE:

• THIS REGISTRATION FORM IS FOR HOSPITALS ONLY. ONLY one registrant per registration form. Hospitals also have the option to attend virtually with unlimited number of hospital staff participating by selecting the Hospital registration option. All sessions will be live streamed with Q&A for our virtual attendees. All sessions will be recorded to allow for playback at your convenience.

• There is a $50 cancellation fee for cancellations prior to August 31. No refunds after August 31.

• All other participants may attend the conference only as an exhibitor and/or as a sponsor (refer to the Exhibitor Prospectus for more information).

Personal Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Address 1:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Phone:
• * What size shirt do you need?

• Promo Code

  Enter Code: Apply

• Fee

  Type	Fee
  Hospital Member Registration - In Person or Virtual	$350.00
  Hospital Wide Registration - Virtual Attendance (unlimited attendees)	$995.00
  Non-member Hospital Registration - In Person or Virtual	$400.00
  Clinic Member Registration - In Person or Virtual	$350.00
  Clinic Wide Registration - Virtual Attendance (unlimited attendees)	$995.00
  Non-Member Clinic Registration - In Person or Virtual	$400.00

Business Information

• * Company:
• * Job Title:

Badge Information

• * Badge Name:

Guest Information

You may add a maximum of 1