Seminar Registration Form

Registration is available to chiropractors and, effective 1/1/2020, to chiropractic students in their final year of school.

Price Breakdown
Total:	$320

Seminar Registration Form

STEP 1

Personal Info

STEP 2

Seminar Info

STEP 3

Payment Info

Create an Account Account Email *
We will use Account Email for account-related notifications and password resets. Username * Enter a password *
Passwords must be at least 8 characters and contain at least one letter and one number. Passwords are case sensitive.

Contact Info Title First Name * Middle Initial Last Name * Family Suffix Professional Suffix Contact Email *
We will use Contact Email for communications from the ICPA. Contact Phone Number *
Cell Phone Number
We will use Cell Phone Number only to text about last minute seminar changes.

School Chiropractic College * Expected Graduation Date *

Office Address Office Name Country * Address * City *

State/Province

Zip/Postal Code * Phone Number * Fax Number Website URL

Shipping/Home Address

For Pathways Magazine and Other Mailings

Contact Name Country * Address * City *

State/Province

Zip/Postal Code * Phone Number *

Request CE Credits ($45)
This can also be requested later through your account.

The following states have approved this seminar in your location for up to 12 hours.
Some states listed may have approved fewer hours.

How did you hear about the seminar? Please check all that apply:
From another member
Conference
Chiropractic College
Google Search
Social Media
Email / Newsletter
BirthFit
Other

Billing Address Same as Shipping

Country * Address * City *

State/Province

Zip/Postal Code *

Credit Card Info Name on Card * Card Number * Expiration *
Month Year
CVC *

Review Your Registration

Assessing and Reducing Risk in the Chiropractic Family Practice (8 Hours)

Anthony Carrino
San Francisco, CA
Dec 12-13, 2020

Venue

Life Chiropractic College West
Room 155A
25001 Industrial Blvd.
Hayward , California 94545

Seminar Hours

Saturday: 8:30 AM - 6:30 PM

Contact Information

Email:
Contact Email:
Contact Phone:
Cell:

Seminar Options

Request CE: No

Payment Info

All attendees must read and agree to the following terms:

I confirm that I have read and agree to the ICPA Seminar Policies and the Adjusting Technique Release Form.

Individual Seminar

Do You Have an Existing Account?

No, I have not created an account yet.