Chiropractor Registration Form

The Diagnosis and Treatment of Knee Disorders

Registration Form for September 25, October 11, and October 18, 2018

Please complete the following registration form.

When you have completed filling it out, you can:

Register Online – Press the submit button. If you are registering more than one person, you will need to fill out the form multiple times.
Register by Mail – Do not press the submit button. Instead, print out this page and mail to: Illinois Sportsmedicine, 1714 N Milwaukee Ave, Glenview, IL 60025. Please fill out a separate form for each person attending the seminar.
Register by Phone – Call us at 847-699-6810 X207 to register by phone. We will need to know the information that is listed in the form below.

Registration Form

First Name*:
Last Name*:

Street Address*:
City*:
State*:
Zip Code*:

Daytime Phone #*:
Email Address*:

License #:

Tuesday, Sep 25th, Maggiano's Little Italy, 1847 Freedom Dr, Naperville
Thursday, October 11th, Maggiano's Little Italy, Old Orchard Center, Skokie
Thursday, October 18th, Maggiano's Little Italy, 516 N Clark St, Chicago

If you have any dietary concerns, please contact us in advance of the seminar by calling Sue at 847-699-6810 X207, These cannot be addressed the evening of the seminar.

For a more detailed description of the menus, please go to the menu page.


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Chiropractor Registration Form

The Diagnosis and Treatment of Knee Disorders

Registration Form for September 25, October 11, and October 18, 2018

Registration Form

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