Physician Registration

ATTENDEE & EVENT REGISTRATION

Please indicate a quantity from each applicable field below. Your selection(s) will calculate automatically and provide a total below.

Spouse/Guest:

Please select

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$200 (anyone over 20)

Spouse/Adult Guest(s) Name(s):

Please enter one full name per line

Children's Fee over 4 yrs. old ($50 per child):

Please select

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Children's Fee under 4 yrs. (no charge):

Please select

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Children over 4 yrs. old Names & Ages

NOTE: Please indicate for First Name, Last Name, Badge Name (and age of children) per line

Children under 4 yrs. Names & Ages

NOTE: Please indicate for First Name, Last Name, Badge Name (and age of children) per line

GOLF

(Optional) Golf Friday at Osprey Course:

$150 per person

Golfers' Names

NOTE: Please indicate for First Name, Last Name, Badge Name per line

Scholarship Contribution

SACS is establishing scholarships to encourage a higher level of participation for the Fellows in Cardiac Care. Contributions are entirely voluntary but if you would like to add an amount of your choosing, please enter that information below.

Conference Scholarship for a Fellow in Adult Congenital Heart Disease (ACHD)

Amount (ACHD)

Conference Scholarship for a Cardiology Fellow

Amount (Cardiology)

Conference Scholarship for a Fellow in Cardiothoracic Surgery

Amount (Cardiothoracic Surgeons)

Accommodations

Reservation*

Please select

Please select
I will make a reservation using the SACS Housing Options. (PREFERRED– contact Kiawah at 800-654-2924 and identify yourself as being with SACS for a wide range of options.)
I will make a reservation through VRBO, or a private booking site.
I do not need a reservation.

Grand Total: $

CANCELLATION / REFUNDS

Cancellation Policy:
On or before June 30: No Cancellation Fee
July 1- on: 50% Cancellation Fee

PAYMENT METHODS

Select Payment Method:*

Credit Card (AX, VI, MC)

Check: Mail to SACS, 10300 Brier Mill Court, Alpharetta, GA 30022

Card Number:*

Name (as it appears on card):*

Billing Address:*

Billing Zip Code:*

Expiration Month:*

Expiration Year:*

CVV:*

Please only press the submit button ONCE. This process may take a few moments to complete as payment will be processed upon submission of this form. Thanks for your patience!

Accommodation Links

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2022

ATTENDEE & EVENT REGISTRATION

GOLF

Scholarship Contribution

Accommodations

Grand Total: $

CANCELLATION / REFUNDS

PAYMENT METHODS

MISSION:

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