Special Guest/Volunteer Registration

Please complete this form so that there is a padfolio and neck wallet for you when you arrive.

If interested in a workshop, they are not included as part of guest or volunteer registration and must be paid for separately. register for the workshops here.

Name *
Video Permissions - This event may be recorded. By attending the San Diego Pain Summit you consent to be photographed, filmed, and/or otherwise recorded. Your entry constitutes your consent to such photography, filming, and/or recording and to any use, in any and all media throughout the universe in perpetuity of your appearance, voice, and name for any purpose whatsoever in connection with the production presently entitled: San Diego Pain Summit. You understand that all photography, filming, and/or recording will be done in reliance on this consent given to you by signing up for this course. *
General Policies - I understand there will be no slide handouts unless the speaker has provided them. Speakers are under no obligation to distribute their slides and I will receive copies only with speaker permission. ~~~~ I understand lunch is not served during the conference or workshops~~~~ I have read all descriptions of speaker biographies, topics, workshops, and the schedule as is available on the Summit website. *
Note: Check a workshop ONLY if we have discussed this in advance, all workshop positions are already filled *** If you are volunteering with a workshop please mark them below. Note- if you are paying for a workshop you are not expected to volunteer during the workshop. *
The 2018 Summit has been approved for continuing education. For $25 you can obtain a certificate as either a guest or volunteer. Check which one applies (please choose only one):