Nonmember Registration

Annual Session 2024 Attendee Registration for Nonmembers

First Name

Last Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Registration Type:

Registered Dental Hygienist (current non-ADHA member)

Dentist

Dental Assistant

Other Office Team Member

Which Days Are You Attending?

Will you require a vegetarian meal option? (Friday, Chipotle)

Yes

On Saturday, general attendee session ends at 12:30, so lunch with the RDH students is OPTIONAL for an additional $10 fee, from 12:30-1:30 PM. Lunch will be available from the Raven Rock Pizza food truck, and your $10 purchase will include 1 Personal Pizza & 1 Drink (soda or water). Students have a session from 1:45-3:00 PM, so will be staying for lunch and then attending their session. All attendees will also have the option to bring cash or card and pay for food in person. If you have any questions, please email Nicole @ AnnualSession@OKDHA.org

*4% online processing fee makes the added total $10.40 per added lunch

Would you like to purchase & attend optional lunch with the RDH students on Saturday, 12:30-1:30 PM, Raven Rock Pizza?

Yes, I would like to purchase an optional Saturday lunch.

No, I do not want to purchase an optional Saturday lunch.

Saturday Lunch (Optional)

Personal Pizza + Drink

Quantity (Personal Pizza + Drink)

Are you attending our FREE Barbie Bowling event? (Bowling & shoes included. Must be age 21+ AFTER 8 PM. Food & Drinks avail. for purchase)

Yes

Are you age 21+?

Yes

No payment items have been selected yet

All requests for refunds must be made in writing to web@okdha.org. Refunds will be considered until July 31st (this must be decided on by our board). After July 31st, no refunds will be issued. Thank you for your understanding.

By selecting this checkbox you are agreeing to our refund policy.