Registration Categories and Fees: Pre-registration deadline is August 15, 2021. Prices increase automatically at 12:01 am on August 16, 2021. Registration fee includes 2 guest or family members that are not dentists or dental team members. There is a $70 registration fee for each additional non- dental guest or family member beginning with the 3rd guest. All guests that are staying on site and/or using the conference links to purchase tickets, etc. must be registered as one of our Disney Attendees or the guest of one of our attendees in order to take advantage of the group discounts for both lodging and tickets.

- ADA Member Dentist / Primary Registrant Team Member $600/675
- ADA Non Member Dentist $850/950
- Student ASDA Member $329/389
- Dental Team Member $328/389
- Non Dentist or Non Team Member Guest $70/85

1. Primary Registrant

2. Name Badge(s)

Include Primary Registrant. Duplicate for additional registrants. Spouses or Guests that are dentist or dental office staff are required to register as an attendee and pay the applicable registration fee. Dental Team Members that do not have a dentist accompanying them must pay the primary registrant rate of $600.

Attendee Name Category

3. Breakfast Tickets
Date Ticket (Yes/No)
Fri, Nov 12
Sat, Nov 13
Sun, Nov 14

4. Friday Night Epcot Fireworks
Name Age

There will be a private group Fireworks Reception at Epcot on November 12 beginning at 8:30 pm. This event will be ticketed per person. Tickets are $45 for adults and $35 for children 10 and under. Ticket price includes 2 beverage tickets for adults 21 years of age and older. You must have your Epcot Park ticket to enter.

5. Payment