Personal Information

Fill out the information below, then click Next to continue. If you are registering multiple people, you will be allowed to add more people to a registration on the third page by clicking the button "Additional Group Registration"

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Who is Attending?

This question is required.
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Add a country code with the + if outside of US and Canada (e.g., +4911111111). We'll use this for mobile login verification.
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Will you be attending the Cocktail party Thursday Evening?

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Enter a number greater than or equal to 1.
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Please indicate any dietary restrictions

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Please select your t-shirt preference

This question is required.
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Please select your t-shirt size

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Consent for Photography and Video Recording

By Registering for Opalescence™ Whitening Extravaganza, you acknowledge that photographs and video recordings may be taken during the event. These may include images in which you are identifiable. We kindly request your explicit consent for the following. 

Consent to the use of photographs and/or video recordings taken during the event for the purposes of: 

  • Event documentation and reporting 
  • Promotional materials (e.g., brochures, websites, social media) 
  • Future marketing of similar events organized by Ultradent Products, Inc. 
  • We will not use your image in any way that could be considered misleading, harmful, or defamatory 

If you do not wish to be photographed or recorded, please inform event staff upon arrival