Home >   Pediatric Conference Registration Fee for KAISER Professionals Reserving a Hotel Package
	Our Price: $475.00 Registrant Information Pre-Title: (Select one) Dr Miss Mr Mrs Ms    First Name*: Middle Initial: Last Name*: Suffix: (Select one) Jr Sr III IV Other    For "Other" suffix, please note in Remarks section below. Post-Title: (Select One) CNM DO MD MD, MBA MD, MPH MD, PhD NP PA PT PharmD PhD Resident RN Other None    For "Other" post-title, please note in Remarks section below. Badge Name: Enter nickname or leave blank if same as above Kaiser Region: (Select One) TPMG KP Northern California SCPMG KP Southern California Colorado PMG KP Colorado Southeast PMG KP Georgia Hawaii PMG KP Hawaii Mid-Atlantic PMG KP Mid-Atlantic States Northwest PMG KP Northwest Ohio PMG KP Ohio Group Health Cooperative Kaiser Division of Research Other Kaiser Permanente Regions Non-Kaiser Permanente    Non-Kaiser Facility or Practice: Facility City: Facility State: Remarks: *Enter remarks or custom post-title here. How did you hear about this meeting: (Select One) Attended previously E-mail bulletin Postcard Received printed brochure Journal listing Website Word of Mouth Other    For "Other," please note in Remarks Hotel Reservation Cancellation Policy*: _I certify that I have read and understand the Cancellation Policy for the 2010 Kaiser Permanente National Pediatric Conference. I accept responsibility for purchasing optional Trip Cancellation Insurance (recommended) to protect against possible financial loss in the event of a last-minute cancellation of my hotel package.

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