Annual Meeting Registration Annual Scientific Assembly Registration 2026 Name (As you would like it to appear on badge) First Last Check Applicable MD DO Resident MD Resident DO Fellow NP Other Registrant T Shirt Size (Adult Sizes)SmallMediumLargeXL2XL3XL4 XLAAFP Member #Cell PhoneEmail(Required) Clinic or Organization Name(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Consent(Required) As an attendee of the MAFP conference, I understand that my name and city will be included in the official attendee list. This list will be provided to exhibitors, sponsors and other registered attendees for networking and communication. The right to withdraw consent at any time by contacting MAFP staff (publicawareness@msafp.org) is available.While in Destin, I will be staying:(Required)On Sandestin property, using MAFP Group Rates.On Sandestin property, but not group rates.Off property.Registration Type(Required) MAFP Active Member $500.00 +3% Processing Fee MAFP Life Member $400.00 + 3% Processing Fee Non-MAFP Member $600.00 +3% Processing Fee Family Medicine Resident $25 + 3% Processing fee Medical Student ($0) Registration fees increase June 20th.Guest/Spouse Registration - Ages 18 & Up(Required) 0 1 Guest $225 2 Guests $450 3 Guests $675 4 Guests $900 Guest registration is $225 (+3% processing fee) for adults or children 18 and over. Includes admission to Exhibit Hall, Family Fun Night, Devotional, Yoga, Awards Luncheon, Bingo, Convention Tshirt. Guest Names, TShirt Size (Adult S – 4XL)For every guest registration, you receive a complimentary conference t-shirt. Children’s Names and AgesPlease list any physical, dietary restrictions, or food allergies that you or any of your guests have:Additional ItemsAre you interested in leading a morning devotional on the Village Lawn? Yes No Sunday, July 20MEMBER - KSA: Pain Management (1 - 5p) Quantity Price: $128.75 Quantity Knowledge Self-Assessment (KSA) Study Groups give you credit for your maintenance of certification through the American Board of Family Medicine. Learners come together to complete the KSA by working through 60 core competency questions. Learners work together to assess, review, and decide the best answer as a group. ABFM awards 8 credits to diplomates who complete each session. NON-MEMBER - KSA: Pain Management (1 - 5p) Quantity Price: $257.50 Quantity MAFP Family Fun Night - (6 - 7:30p) Quantity Price: $0.00 Quantity Included with RegistrationMAFP New Physician Happy Hour - (6 - 7:30p) Quantity Price: $0.00 Quantity Included with RegistrationMonday, July 21Golf Tournament at The Raven - (Monday 2p) Quantity Price: $133.90 Quantity Shotgun startFoursome:Superhero Parade and Movie (3p) Quantity Price: $0.00 Quantity Included with RegistrationTuesday, July 22MAFP Awards Lunch (Members Only) - Tuesday, July 21 12:30p Quantity Price: $0.00 Quantity Included with RegistrationMAFP Awards Lunch EXTRA Tickets - 12:30p Quantity Price: $51.50 Quantity Kid's Bingo - 10a Quantity Price: $0.00 Quantity Included with Registration. Kids are welcome but will receive kids prize. Adult Bingo - 4p Quantity Price: $0.00 Quantity Included with Registration. Kids are welcome but will receive kids prize. Family Crab Hunt (Tuesday Evening) Quantity Price: $0.00 Quantity Included with RegistrationSponsor a Student/Resident Quantity Price: $51.50 Quantity Your contribution will directly help offset the cost of medical students and residents' rooms & convention expenses. You will receive a Student Supporter ribbon.MAFP Split the Pot Drawing Quantity Price: $103.00 Quantity If I win, please donate this amount to the FoundationEnter amount you'd like donated to the foundationEXTRA ITEMS: The items below will be waiting for you at the Registration Desk.Water Color Painting Quantity Price: $51.50 Quantity 12 x 15 Family Medicine print, signed and numbered by artist Katie Erickson. (Special price for Annual Meeting attendees only.)Images Book Quantity Price: $51.50 Quantity Images in MS Medicine book by family physician Dr. Luke LamptonMAFP Swag Pre-OrderMAFP T Shirt Quantity Price: $15.45 Quantity UntitledButter YellowDark GreenGreyKatie CoralKelly GreenNavyPowder BlueWhiteMAFP T Shirt Size (Adult Sizes)SmallMediumLargeXL2XL3XL4 XLMAFP Sweatshirt Quantity Price: $30.09 Quantity MAFP Sweatshirt Size (Adult Sizes)SmallMediumLargeXL2XL3XL4 XLMAFP Sweatshirt Color ChoiceGreyNavyPowder BlueWhiteMAFP Hat Quantity Price: $30.09 Quantity MAFP Hat Color ChoiceBlackPinkWhiteTotal Credit CardCard Details Cardholder Name Please note that a 3% credit card processing fee has been added to this transaction. Children 18 Years or Older: Children 18 years or older who plan to attend any functions listed on this form must pay the Guest registration fee. Cancellation Policy: In the event your registration must be cancelled, your fee (less $75) will be refunded if we are notified by June 25. No refunds will be made after June 25. NO REGISTRATIONS OR ACTIVITIES MAY BE CANCELLED AFTER ARRIVING AT CONVENTION. Attendee list will include those who have registered by July 6, 2025. T-shirt size requests will be taken until June 10. After that, your size availability is NOT guaranteed. UntitledFirst ChoiceSecond ChoiceThird Choice Δ
