The Mastocytosis Society - 2013 Conference Registration Form

The 19th Annual TMS conference is rapidly approaching! Register now to join Mast Cell Disease patients, family members, friends, caregivers and physicians in a supportive and educational environment. There will also be plenty of time to mix, mingle and relax. Don't forget to bring your walking shoes so that you may join in the TMS Walk-a-thon. Early registrations must be received by September 1, 2013 in order to qualify for the discounted rate shown.

TMS is pleased to be able to offer affordable registration rates by subsidizing the conference costs. Actual conference costs are over $300 per attendee. If you would like to make a donation to contribute to the conference fund to help make subsidized rates possible, please indicate your additional tax-deductible contribution. Conference fee includes three full breakfasts, morning and afternoon snacks, Friday luncheon, Saturday luncheon, transportation to and from the Walk-a-thon, plus conference materials and all presentations. Tickets are also available for the Physician and Volunteer Appreciation Dinner and Celebration Saturday evening. **Payment must accompany Registration; unpaid registrations will be canceled Sept. 2nd without other arrangements. Paypal payment is made in the next step**

Cancellation Policy: Cancellations must be received in writing at the above listed address by 5 PM on October 10, 2012, in order to receive a full refund. After that date, refunds will granted depending on circumstances and will be determined by the TMS Board of Directors. Conference materials may be shipped upon request to paid registrants who are unable to attend the conference. Hotel cancellations must be made separately and directly with the hotel.

Your Information

Phone Number:

First Name:

Last Name:

Address Line 1:

Address Line 2:



Zip Code:


***Be sure to pay for all attendees in the next step of this registration.

Other Attendee Information
This section is is for anyone that will be attending with you.
Children from birth to age 3 years, 11 mos. may attend for free, but please register them if they will participate in the childcare room. Thank You.

Please list the names and ages of anyone attending with you separated by commas:

Number of Children:
I am interested in having my children participate in a childcare room including activities.

Any special instructions:

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