2026 The MyoSphere presents

2026 Registration Form

First name

Last name

Enter the name you would like on your Name Tag (i.e., nickname)

Multi-line address

Country/Region

Address

City

Zip / Postal code

Company name

Phone

What is your profession/credentials?

Enter your full professional title, including all credentials, as you would like it to appear on your name tag.

How will you join? (You can change this later)

In-person

Virtually

Watch Recording (Must complete by 5/31/26 for ASHA CEUs)

ASHA and AGD CEUs will be AVAILABLE for online. ASHA CEUs will be available for recording too!

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CEU Reporting

Would you like CEUs reported?

If you selected ASHA/AGD, please enter your ID number.

Please enter your name as it appears in your ASHA or AGD records. This is typically your professional name, not a nickname.

NOTE: Everyone will receive a Certificate of Completion for the Symposium.

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Group Discount

Are you registering with a group of 3 or more (yourself and two other people)?

Yes

How many will attend?

NOTE: Use discount code MYOGROUP27 at checkout

Group Name or Tag

Type "N/A" if you are not registering with a group.

Create a unique group name (e.g., “SmileTeam2025” or “DrJonesGroup”) to share with your group members. Everyone must enter the same group name during registration-- Type "N/A" if you are not registering with a group.

Everyone must enter the same group name.

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Attendee Tags

Tag: Select one:

Year 1 – First Time!

Year 2 – Back Again!

Year 3 – I'm a Regular!

Year 4 – Myo Veteran!

Comments or Questions:

If you have any questions, special requests, or details you'd like us to know, feel free to leave them here:

Need to reach us directly?

Email: info@themyosphere.com

REQUIRED Please confirm that you understand the policies listed at the bottom of this registration page under Disclosures, Cancellations, Substitutions.

GROUPS PLEASE READ THIS INFORMATION CAREFULLY!

If you are registering as GROUP and want to send a check for payment, CHECK the box to the left.
Click Check Out below to complete your registration. On the next page you will NOT enter payment information. Simply close the form which will hold your seat.
Make check PAYABLE to Karen Masters and mail to: Karen Masters
318 Main St
Apt #31
Madison NJ, 07940
PLEASE SEND CHECK WITHIN TWO WEEKS OF REGISTRATION TO HOLD YOUR SEAT!

PAYING BY CHECK Check this box and follow the directions in #2, #3, and #4 above.

Questions? Email info@themyosphere.com

The MyoSphere Registration

$850

2026 The MyoSphere presents

2026 Registration Form

Email: info@themyosphere.com