First Year DC Convention Registration

Please read and fill out the Registration form below.

No registration will be accepted without payment.

If you are planning to check out as a guest using PayPal, you must either use Firefox or Brave browsers. PayPal has blocked other browsers from allowing guests to check out without making an account.

Last Name *

First Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Email Address *

Chiropractic License Number *

Name & Address As It Appears on Your Chiropractic License *

Month & Year Graduated *

Your registration includes ONE lunch ticket. Please indicate how many ADDITIONAL tickets you wish to purchase at $40 each.

Your registration includes ONE dinner ticket. Please indicate how many ADDITIONAL tickets you wish to purchase at $50 each.

Do you want to purchase a ticket for your staff/spouse/student at $30? (This includes lunch, does not include dinner.)

Your registration includes one state CE (Continuing Education) certificate. Please indicate how many additional state CE certificates you wish to purchase at $50 each.

What Other State Are You Licensed In?

What Is Your License Number?

Registration Fee *$99

Registration Fee TotalIncludes your registration fee and all selected extra tickets

Cancellation Policy *Please acknowledge that if you cancel more than one week before the event, there is a $50 administrative fee. There is no refund if you cancel 7 days prior to the event.By checking the box above, you acknowledge that you have read and will abide by our cancellation policy.

Choose Your Payment Method *PayPalStripe

Credit Card Payment Option

PLEASE NOTE: You do not need a Paypal account to pay your registration fee. When you click the Paypal button, you may enter a separate Credit or Debit Card as your payment option by clicking the button titled "Pay with Debit or Credit Card."

Credit Card Payment Option

PLEASE NOTE: You do not need a Stripe account to pay your registration fee. You can simply enter your credit or debit card information into the Stripe payment field.

Credit / Debit Card *

** Cancellation Policy: Full refund minus $50 administrative fee if requested 7 days prior to event. No refunds after that time.

** If you are not a GSCS member, $50 of your registration fee may be applied to GSCS membership
(new members only) with your completed application.