Live Peak Exchange Confirmation Form

Name*

First NameLast Name

Email*

example@example.com

Email Permissions*

By checking this box, I am opting in to share my email address with companies that are participating in the program.By checking this box, I am opting out of sharing my email address with companies that are participating in the program.

Thank you for agreeing to participate in the Peak Exchange Reverse Expo as one of our Pharmacy and Administration Leadership participants or Clinical Thought Leaders (PALs/CTLs). The reverse expo will take place October 18, 2025 in conjunction with HOPCON - New England at the Westin Waltham Boston. This form provides additional information regarding your participation.

Session:
Saturday, October 18
2:30 - 4:30pm

The Westin Waltham Boston
70 Third Avenue
Waltham, MA 02451

Please give order of preference. Click & drag each option to your desired position: 1st, 2nd, or 3rd preferred slot.

Registration and Travel Details

As a participant in the Peak Exchange, you will receive complimentary full conference registration to HOPCON - New England. After you complete this form, a discount code will be emailed to you. This code will waive your fee when you register for the meeting at hop-con.com. In addition to a waived registration fee, you will also receive a travel stipend. You may decline this offer.

Please sign the participant agreement (Appendix I) below. Please email peakexchange@cesynergy.com with any additional questions or comments regarding the contents of this letter. A registration agreement that discusses the full terms of this event will be sent to you via email for completion.

Thank you for your participation in the Peak Exchange at HOPCON. We look forward to seeing you in October in Waltham!

Appendix I

Participant Confirmation

I, Name* , have reviewed the information in this letter and agree to participate in the Peak Exchange Reverse Expo, under the terms stated, which is scheduled for October 18, 2025 at the Westin Waltham Boston.

Name (including credentials):Name*
Title:Title*
Institution: Institution*

Signature*

Date*

Date