Name of Person Completing this Agreement *

First Name

Last Name

Phone *

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Name of Attending Rep

(if different than above)

First Name

Last Name

Select the Meeting(s) You Plan to Attend *

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Kidney Cancer: 12/06/2023

Gender Identity Care: 01/10/2024

Men's Health: 02/07/2024

Bladder Cancer: 03/06/2024

Urological Complication Management: 04/03/2024

Payment Type *

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Exhibitor Agreement *

Upon submitting this agreement, the Exhibitor and the Chicago Urological Society understand and agree that the Illinois State Medical Society (accredited provider) policy will not allow the Chicago Urological Society to accept any advice or services from the Exhibitor concerning speakers, authors, participants or other CME matters, including content, as conditions of the exhibit fee, exhibitor placement and/or sponsorship selection. In addition, both parties fully understand and agree that this agreement, and therefore the conference, is free from any commercial bias or control due to the separation of the designated exhibitor and sponsorship area, and related activities, from the CME planners, authors, speakers, and CME sessions.

I agree