Registration
21C Hotel, Bentonville AR      10 am to 2:30 pm      Lunch provided
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Seating is limited.  Please notify the Audrey Harris Vision if you register and cannot attend.
First Name *
Last Name *
Home Address *
Email Address *
Credentials *
Hospital Employer *
I acknowledge that I agree to assume the risk and responsibility for any injury or illness I may incur as a result of attending this event, and that the hosts will be held harmless by me for any such injury or illness. *
Required
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