Registration Form

First Name *

Last Name *

Designation (MD, DO, BSc etc)

Institution/Company *

Email Address *

All registrations include scientific sessions access, CME, Breakfasts, Welcome Reception, and Presidential Banquet. Note: Only registered attendees or guests may RSVP for the Presidential Banquet.

Registration Type(s): *

SCVSS Active Member ($350.00)

SCVSS Retired Member ($175.00)

Non-Member Physician ($450.00)

Non-MD Allied Health Professional ($175.00)

Resident or Fellow ($175.00)

Medical Student (FREE)

Guest/Spouse ($100.00)

Payment Type: *

Visa

Mastercard

Amex

Expiration *

Card number last 4 digits: *

Guest/Spouse Full Name:

Do you plan to attend the Presidential Banquet on Saturday 5th? *

Yes, I will attend myself

Yes, I will attend with my guest/spouse

Yes, I will attend with my guest/spouse and children

No, I will not be attending

The 2025 Presidential Banquet is intended to be an adult-only dinner. Enjoy it!
Drop off the children ages 5 and up down the hall for an concurrent event geared just for them.

5:00pm Kids buffet opens with all the good stuff like pizza and chicken strips

5:30pm The show begins with the San Diego Science Guys program called Ready, Set, SHOCK!

7:30pm Collection you kids and hear all about the fun!

The kids will have a blast with the van De Graff creating electrical current. Learn how to make make your hair stand up and watch current travel around a human circuit. There will be laughter and Bubble Bubbles Bubbles! Buy tickets for this event below and watch for an RSVP email with more details and family information form.

Please enter the number of tickets you like to purchase for our concurrent children's event ($50 per child, 5yr old and above):

Child Ticket - Ages 5+ ($50 each)

Would you like to add a donation to the Robert J. Hye Fund? If so, please indicate amount:

Questions?

Please email admin@surgicalcs.com

or call Heather Roderick at (360) 420-6906