Clone of PrimeFare East 2025 Attendee Registration Form

Attendee Registration Form

PrimeFare East Regional Scientific Symposium 2026

Chattanooga Marriott Downtown and Chattanooga Convention Center

Friday & Saturday, June 19th & 20th

Two Carter Plaza, Chattanooga, TN 37402

Each attendee registration includes all meals and breaks as well as any combination of educational sessions to satisfy your certification requirements.

Your Company Name*

Company Contact Information*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Attendee #1*

	Please Answer for Each Attendee
ABC/BOC/State Certifications
Name of Attendee for Badge
Email Address of Attendee
Phone Number of Attendee

T-Shirt Size*

Attendee #2

	Please Answer for Each Attendee
ABC/BOC/State Certifications
Name of Attendee for Badge
Emall Address of Attendee
Phone Number of Attendee

T-Shirt Size

Attendee #3

	Please Answer for Each Attendee
ABC/BOC Certification
Name of Attendee for Badge
Emall Address of Attendee
Phone Number of Attendee

T-Shirt Size

Attendee #4

	Please Answer for Each Attendee
ABC/BOC Certification
Name of Attendee for Badge
Emall Address of Attendee
Phone Number of Attendee

T-Shirt Size

Attendee #5

	Please Answer for Each Attendee
ABC/BOC Certification
Name of Attendee for Badge
Emall Address of Attendee
Phone Number of Attendee

T-Shirt Size

Please Make Note of the Meeting Format:

Registration and breakfast begin at 7am on Friday, 6/19/26 and breakfast at 7am on Saturday, 6/20/26.

Educational sessions begin at 8am both days.

Attendees must make their own hotel reservations: Contact the hotel directly and mention the PrimeFare East meeting for the special rate of $189.00 per night.

Chattannoga Marriott Downtown and Chattanooga Convention Center

Two Carter Plaza, Chattanooga, TN 37402 (423)756-0002

Or use this link: Book your group rate for PrimeFare East 2026

No Refunds: Our policy is that if the event can't be held for any reason, we will provide a credit for paid registrants for an alternate meeting date.

Please contact us at 901-359-3936, primecarepruitt@gmail.com with questions.

Attendee Registration Quantity*

PrimeFare East Regional Scientific Symposium (Early Bird Rate)Attendee Registration PrimeFare East 2026

$550 Quantity
Item subtotal:$0.00

Additional Guest Meal(s)$50.00 additional for each meal.

$50 Quantity

Total

$0.00

Credit Card