IMGA 2026 Registration - Member Only - Independent Medical Group Alliance

IMGA 2026 Member Registration

IMGA 2026 will take place from September 24 – 26, 2026 at the Stein Eriksen in Park City, UT.

IMGA member groups receive complimentary Annual Forum registration for two attendees. If you only wish to register one attendee at this time, you may return to this form later to register the second attendee.

If you wish to register a third representative, this can be done at the additional base cost of $750 by completing this form.

First Attendee

Name(Required)

First Last

Title(Required)

Practice(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone(Required)

Email(Required)

Does the attendee have any disabilities or dietary restrictions?

Is there another contact (i.e. assistant) we should communicate with regarding your registration?

Include name, email, and phone

Number of guests (spouse and/or children):

Guest name(s):

This will help us prepare name tags for your guests if they join us at the evening receptions.

Are you registering a second attendee at this time?

Yes

Second Attendee