2025 Annual Conference Attendee Registration Form (Proliance)

2025 Annual Education Conference & Trade Show Attendee Registration (Proliance)

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Washington Ambulatory Surgery Center Association
2025 Annual Education Conference & Trade Show
Tulalip Resort & Spa
10200 Quil Ceda Boulevard
Tulalip, WA 98271
November 5-7, 2025

Primary Contact Name*

First Last

Primary Contact Title*

Primary Contact Company*

Primary Contact Address

Street Address Address Line 2 City State ZIP Code

Primary Contact Phone*

Primary Contact Email*

Breakout sessions will occur on Friday, November 7, 2025. Please indicate the sessions that you plan to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Member Pricing Code

Please enter the member pricing code we provided to enable member pricing.

Member Conference Registration Fees*

WASCA Member - $650

Member – Thursday only - $575

Member – Friday only - $575

Member Wednesday Workshops

Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $169

No Registration for Wednesday Workshops

Non-Member Conference Registration Fees*

Non-Member - $850 (Member Price: $650)

Non-Member – Thursday only - $825 (Member Price: $575)

Non-Member – Friday only - $825 (Member Price: $575)

Non-Member Wednesday Workshops

Non Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $199 (Member Price: $169)

No Registration for Wednesday Workshops

For those registering for Wednesday's events, please indicate the workshops you plan to attend below:

Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Surgical Waste Management

Additional WASCA Member Registrations

Each additional registration is $500/registrant

Additional Member 1 Name*

First Last

Additional Member 1 Title

Additional Member 1 Company*

Additional Member 1 Address

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

Additional Member 1 Phone

Additional Member 1 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Member 1 Wednesday Workshops

Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $169

No Registration for Wednesday Workshops

Additional Member 1 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Member 1 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Member 1 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Member 2 Name

First Last

Additional Member 2 Title

Additional Member 2 Company*

Additional Member 2 Address

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

Additional Member 2 Phone

Additional Member 2 Email

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Member 2 Wednesday Workshops

Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $169

No Registration for Wednesday Workshops

Additional Member 2 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Member 2 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Member 2 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Member 3 Name*

First Last

Additional Member 3 Title

Additional Member 3 Company*

Additional Member 3 Address

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

Additional Member 3 Phone

Additional Member 3 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Member 3 Wednesday Workshops

Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $169

No Registration for Wednesday Workshops

Additional Member 3 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Member 3 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Member 3 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Member 4 Name*

First Last

Additional Member 4 Title

Additional Member 4 Company*

Additional Member 4 Address

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

Additional Member 4 Phone

Additional Member 4 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Member 4 Wednesday Workshops

Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $169

No Registration for Wednesday Workshops

Additional Member 4 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Member 4 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Member 4 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional WASCA Non-Member Registrations

Each additional registration is $650/registrant

Additional Non-Member 1 Name*

First Last

Additional Non-Member 1 Title

Additional Non-Member 1 Company*

Additional Non-Member 1 Address

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

Additional Non-Member 1 Phone

Additional Non-Member 1 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Non-Member 1 Wednesday Workshops

Non Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $199 (Member Price: $169)

No Registration for Wednesday Workshops

Additional Non-Member 1 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Non-Member 1 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Non-Member 1 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Non-Member 2 Name*

First Last

Additional Non-Member 2 Title

Additional Non-Member 2 Company*

Additional Non-Member 2 Address

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

Additional Non-Member 2 Phone

Additional Non-Member 2 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Non-Member 2 Wednesday Workshops

Non Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $199 (Member Price: $169)

No Registration for Wednesday Workshops

Additional Non-Member 2 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Non-Member 2 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Non-Member 2 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Non-Member 3 Name*

First Last

Additional Non-Member 3 Title

Additional Non-Member 3 Company*

Additional Non-Member 3 Address

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

Additional Non-Member 3 Phone

Additional Non-Member 3 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Non-Member 3 Wednesday Workshops

Non Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $199 (Member Price: $169)

No Registration for Wednesday Workshops

Additional Non-Member 3 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Non-Member 3 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Non-Member 3 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

Additional Non-Member 4 Name*

First Last

Additional Non-Member 4 Title

Additional Non-Member 4 Company*

Additional Non-Member 4 Address

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

Additional Non-Member 4 Phone

Additional Non-Member 4 Email*

Breakout sessions will occur on Friday, November 8, 2024. Please indicate the sessions that you paln to attend (if any).

Breakout Session 1 (10:30-11:30am):

Hand Hygiene

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 1 of 2 part session)

Breakout Session 2 (11:30-12:30pm):

SSIs & Prevention

Leadership/Mentoring/Development: Developing the Next Generation of Leadership (Part 2 of 2 part session)

Additional Non-Member 4 Wednesday Workshops

Non Member - Wednesday Workshops, Networking Mixer & Rapid Connections Events, 1:30pm - 6:00pm - $199 (Member Price: $169)

No Registration for Wednesday Workshops

Additional Non-Member 4 Wednesday Workshop 1

1:30 - 2:30pm From Compliance to Confidence for Administrators: Keeping Up with ASC Regulations & Standardsice

1:30 - 2:30pm From Findings to Fixes: Tackling QUAD A's Top ASC Survey Deficiencies

Additional Non-Member 4 Wednesday Workshop 2

2:40 - 3:40pm Hidden Refunds: How WA ASCs Can Recover Overpaid Sales & B&O Taxes

2:40 - 3:40pm Crisis Ready: Blending Emergency Planning with Violence Prevention

Additional Non-Member 4 Wednesday Workshop 3

3:50 - 4:50pm Recent Accreditation Survey Trends & What's Coming

3:50 - 4:50pm Exhibitor Workshop TBD

TOTAL

*Please note: WASCA does not accept payment via check for annual conference registration.

Payment Method*

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Expiration Date

Security Code Cardholder Name

50% refund of registration fees available until Monday, September 8, 2025. No refunds will be issued as of Tuesday, September 9, 2025. Transfer of registration fees to another colleague or industry member is allowed.

INQUIRIES: Contact the WASCA Office at info@wasca.net