2025 Region IX Clinical Excellence and Leadership Conference Exhibitor/Sponsor Registration Form

June 22 - 24, 2025

The Peppermill Resort & Spa | Reno, NV

Step 1

Organization and Booth Contact Information

This name will be displayed on all conference materials. You may skip if this is the same name as above.

The main contact listed will receive all important conference information. Please ensure that the contact details are correct, as this person is responsible for relaying this information to the necessary booth registrants.


Step 2

Level of Participation & Payment


2025 Conference Sponsorship Prospectus

EXHIBITOR & SPONSORSHIP LEVEL*

This must be the level agreed upon with CPCA.

Step 3

Exhibitor Personnel Information


If your selected sponsorship comes with a booth, please provide the names of those individuals who will staff it during the conference. If your sponsorship comes with additional comped badges, email the names to sponsor@cpca.org.


All sponsors receive an Excel pre-attendee list as part of their package. If you are exhibiting only, your order includes a printed attendee list, which will be provided upon arrival during move-in the day before the conference. If you would like to purchase an Excel pre-attendee list for an additional $500, please select this option. The list will be sent on Thursday, February 13th.


In addition to the above sums, if any payment due is not timely made by the event date, in addition to the sum due there shall be a late payment penalty due in an amount equal to $100. Additionally, in the event payment is not received in full subsequently, additional $100 late fees will be assessed every 30 days after the event date until full payment and penalties are received.


Please acknowledge your agreement with the late fee policy by initialing below. Should you have any further inquiries, please feel free to reach out to us via email at sponsor@cpca.org

Select
Caret IconCaret symbol

California Primary Care Association

1231 I St. Suite 400

Sacramento, CA 95814


First Citizen Bank

Accounting #: 009371385756

Routing #: 122037760

Please list the email address for the person responsible for payment. Invoices must be paid in full by the event date or late fees will apply (find late fee language above).

Tax Identification Number

IRS Code Section 501(c) Status (if applicable)


Step 4

Exhibitor Conditions & Agreement


Before checking this box, click here to review the terms and conditions of your application and contract via printable pdf.


Please save a copy for your records.

By checking this box I certify that I have reviewed and agree to the terms and conditions.

Step 5

Tell us about yourself.

Please submit your high-resolution logo (pdf or eps files preferred).


Your logo will be featured on our Exhibitor Bingo card.

Drag and drop files here or

What category of service do you offer?

Confirmation Information

After completing and submitting this registration form, you will be officially registered as an exhibitor or sponsor for the 2025 Region IX Clinical Excellence and Leadership Conference. A confirmation email will be promptly sent to your provided email address, affirming your successful registration. Should you have any inquiries or require further assistance, please don't hesitate to contact us at sponsor@cpca.org. We look forward to welcoming you at the conference in June!

Please save a copy for your records.