nebraska chapter of the american college of … · governor’s message by william a....

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Governor’s Message By William A. Shiffermiller, MD, FACP INSIDE THIS ISSUE: Governor’s Message 2013 Leadership Day 2013 Annual Meeting Brochure and Registration NEBRASKA CHAPTER OF THE AMERICAN COLLEGE OF PHYSICIANS AUGUST 2013 Nebraska Dear Colleagues: 2013 is looking again to be a produc9ve year for the ACP. Locally Dr. Tom Tape has transi9oned from Chair of the Board of Governors to a Regent of the College. Dr. Micah Beachy has been appointed to the Council of Early Career Physicians. Dr. Beachy and Dr. Jason Shiffermiller collaborated on a state health policy mee9ng in March to discuss issues as well as how the local chapter can advocate with state officials on legisla9on of interest. Kris Rahm, with help from Laurie Braun, con9nues to provide exemplary services as the Execu9ve Director of our Chapter. Our chapter mee9ng will be held at the downtown Hilton in Omaha on October 17 and 18th and I an9cipate will be as always a produc9ve educa9onal opportunity. Na9onally the spring mee9ng in San Francisco met expecta9ons and con9nues to be, in my mind, the best internal medical medicine educa9onal value available. The Nebraska chapter again took part in the Leadership day, which was held in Washington, DC under the direc9on of Dr. Jason Shiffermiller, Chair of the HPPC. Please read his report which is included in this newsleTer. Also at the spring mee9ng in San Francisco, several resolu9ons of interest were presented. One explored financial collabora9on between longterm care facili9es and hospitals to reduce cost and improve quality by aligning incen9ves. Another expressed the desire to limit the Medicare annual visit to only primary care. A further explored whether the hospital medicine cer9fica9on track was a produc9ve addi9on to recer9fica9on or not. Inves9ga9ng and promo9ng methods of effec9ve communica9on within electronic medical record systems was the subject of another and how to enhance the value of membership in the ACP for large prac9ce groups and associa9ons was another project. Finally was a proposal encouraging the American College of Graduate Medical Educa9on to develop and maintain evidencebased requirements for residency programs. I con9nue to be encouraged by the ACP’s support of lifelong educa9on in internal medicine and its con9nued advocacy of parsimonious and effec9ve medical care for the popula9on we serve. I hope to see you at the annual mee9ng (please see brochure below).

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Page 1: NEBRASKA CHAPTER OF THE AMERICAN COLLEGE OF … · Governor’s Message By William A. Shiffermiller, MD, FACP INSIDE THIS ISSUE: Governor’s Message 2013 Leadership Day 2013 Annual

Governor’s Message By William A. Shiffermiller, MD, FACP

INSIDE THIS ISSUE:

Governor’s Message

2013 Leadership Day

2013 Annual Meeting Brochure and Registration

NEBRASKA CHAPTER OF THE AMERICAN COLLEGE OF PHYSICIANS AUGUST 2013

Nebraska

Dear  Colleagues:

2013  is  looking  again  to  be  a  produc9ve  year  for   the  ACP.    Locally  Dr.  Tom  Tape  has  transi9oned  from  Chair  of  the  Board  of  Governors  to  a  Regent  of  the  College.    Dr.  Micah  Beachy  has  been  appointed  to  the  Council  of  Early  Career  Physicians.    Dr.  Beachy  and  Dr.  Jason  Shiffermiller  collaborated  on  a  state  health  policy  mee9ng  in  March  to  discuss  issues  as  well  as  how  the  local  chapter  can  advocate  with  state  officials  on  legisla9on  of  interest.  

Kris  Rahm,  with  help  from  Laurie  Braun,  con9nues    to  provide  exemplary  services  as  the  Execu9ve  Director   of  our   Chapter.     Our     chapter  mee9ng  will  be  held  at   the  downtown   Hilton   in   Omaha  on   October  17   and  18th  and  I  an9cipate  will  be  as  always  a  produc9ve  educa9onal    opportunity.  Na9onally   the   spring   mee9ng   in   San   Francisco   met   expecta9ons   and  con9nues   to   be,   in   my   mind,   the   best   internal   medical   medicine  educa9onal  value  available.     The  Nebraska  chapter   again  took  part   in  the  Leadership  day,  which  was  held  in  Washington,  DC  under  the  direc9on  of  Dr.  Jason  Shiffermiller,  Chair  of  the  HPPC.    Please  read  his  report  which  is  included  in  this  newsleTer.

Also  at  the  spring  mee9ng  in  San  Francisco,  several  resolu9ons  of  interest  were  presented.    One  explored  financial  collabora9on  between  long-­‐term  care  facili9es  and  hospitals  to  reduce  cost  and  improve  quality  by  aligning  incen9ves.    Another  expressed  the  desire  to  limit  the  Medicare  annual  visit  to  only   primary   care.    A  further    explored  whether  the  hospital  medicine  cer9fica9on   track   was   a   produc9ve   addi9on   to   recer9fica9on   or   not.    Inves9ga9ng   and   promo9ng  methods  of   effec9ve  communica9on  within  electronic  medical  record  systems  was  the  subject  of  another  and  how  to  enhance  the  value  of  membership  in  the  ACP  for  large    prac9ce  groups  and  associa9ons  was  another  project.    Finally  was  a  proposal  encouraging  the  American  College  of  Graduate  Medical  Educa9on  to  develop  and  maintain  evidence-­‐based  requirements  for  residency  programs.  I  con9nue  to  be  encouraged  by   the  ACP’s  support  of  lifelong  educa9on  in  internal   medicine   and   its   con9nued   advocacy   of   parsimonious   and  effec9ve  medical  care  for  the  popula9on  we  serve.  I  hope  to  see  you  at  the  annual  mee9ng  (please  see  brochure  below).    

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NEBRASKA CHAPTER OF THE AMERICAN COLLEGE OF PHYSICIANS AUGUST 2013

2013 Leadership Day By Jason Shiffermiller, MD, FACP

Each  year,   ACP  Services,   Inc.   organizes  an  advocacy   event   in  Washington  DC   that   helps  ACP  members  connect  with  their  Congressional  Representa9ves  on  issues  important  to  internal  medicine.    For  those  of  you  not   familiar  with  ACP   Services,   this   is  a  separate   professional  membership  associa9on  created   in  1998  to  provide  advocacy  and  other  services  to  internist-­‐members.    This  year,  the  event  was  held  on  May  21st  and  22nd.    ATendance   con9nues  to   increase,  overall  and  Nebraska’s  con9ngency  grew   to  eight  and  consisted  of  two  tradi9onal  prac9ce   internists,  three   academic  internists  of  whom   two  are  hospitalists,  one  resident  from  each  medical  school,  and  one  very  dedicated  medical  student.    The  group  included  our  Governor,  Dr.  William  Shiffermiller,  and  the  president  of  ACP  services,  Dr.  Thomas  Tape.

Once  again  this  year,  we  asked  the  Nebraska  Members  of  Congress  to  eliminate   the  Sustainable  Growth  Rate  (SGR)  formula  as  a  method  for  controlling  health  care  costs.    We  offered  them  a  reasoned  approach  to  transi9oning  to  one  or  more  new  payment  models.    ACP  has  been  advoca9ng  that  same  approach  to  the   House  Ways  and  Means  CommiTee   and   the  House   Energy  and  Commerce   CommiTee   throughout  this  spring.    Those  commiTees  have  joint  responsibility  for  managing  Medicare  and  have  created  a  broad  proposal  for  repealing  the   SGR  that   is  largely  consistent  with  ACP’s  recommenda9ons.    A  bipar9san  bill  has  also  been  introduced  in  the  House  (H.R.  574)  that  seeks  to  achieve  many  of  the   same  changes.    ACP  was  also  recently  asked  to  provide   recommenda9ons  for  SGR   repeal  to  the   Senate   Finance  CommiTee  which  has  sole   jurisdic9on  over  Medicare   on   the  Senate   side.     The   response   to   that   request   has  been  posted  online   at  hTp://www.acponline.org/acp_policy/leTers/acp_response_to_sfc_2013.pdf  .     In  total,  this   represents   more   interest   in   SGR   reform   on   Capitol   Hill   than   I   have   seen   in   the   last   five   years  combined.    

In   addi9on   to   SGR   reform,   we   brought   several   other   maTers   to   the   aTen9on   of   our   Senators   and  Representa9ves.    They  did  not   seem   to  be  aware   that   UNMC  Chancellor,  Dr.  Harold  Maurer,  has  been  appointed  to  the  Na9onal  Health  Care  Workforce  Commission.    This  commission  was  created  by  the  ACA  but  has  not  yet  been  allowed  to  meet  because  congress  has  not  approved  its  funding.    The  commission  is  charged  with  making   recommending  that  would  align  federal  policy  with  real-­‐world  physician  workforce  needs.     As  of   now,   that   charge   goes  unanswered.     In   a   similar   vein,   we   spoke   at   length   with   our  Congressional  offices  about   reforming   the  Graduate  Medical  Educa9on  (GME)  funding   system.     Finally,  we  presented  them  with  what  I  think  are  innova9ve  ideas  for  reform  of  the  medical  liability  court  system.    Although   that   issue   certainly  didn’t   resonate  with  all  of   our  Congressmen,   it   tends  to  be  more   popular  among  Republicans  and  did  get  a  few  posi9ve  responses  from  Nebraska’s  100%  Republican  delega9on.

Overall,   it  was  an  interes9ng  and  exci9ng  Leadership  Day.    Congress  seems  to  be  slowly  moving  on  some  of   our   priority   issues.     Nebraska’s   congressional   offices  made   us   feel  welcome   and   were   willing   to  par9cipate   in   meaningful   discussion   about   the   prac9ce   of   internal   medicine.     Despite   the   fiscal  environment,   we   are   looking   forward   to   the   developments   that   the   coming   year   brings.     If   you   are  interested  in  aTending  Leadership  Day  in  2014,  please  contact  me  at  [email protected]

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NEBRASKA CHAPTER OF THE AMERICAN COLLEGE OF PHYSICIANS AUGUST 2013

2013NE ACP Delegation:

Rich Seitz,

Tom Tape,

Micah Beachy,

Keenan Taylor,

Sen. Mike Johanns

Jason Shiffermiller,

Jason Lambrecht,

Caitlin Muir and

Bill Shiffermiller

LEADERSHIP  

DAY

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NEBRASKA

ACP SCIENTIFIC MEETING

Hilton Omaha

This educational activity has been designated for 11 CME credits.

October 17-18Omaha, NE

2013

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PROGRAM SCHEDULE:

Thursday,       11:30  am     Governor’s  Advisory  Council  Mee9ng

October  17       12:30  pm     Registra9on  Begins

        1:25  pm     Welcome  -­‐  William  Shiffermiller,  Governor

        1:30  pm     AGernoon  Session  Begins

                Pallavi  Bellamkonda,  Moderator

        1:30  pm     SEP  Module  -­‐  Hospital  Based  Medicine  -­‐  Part  I

                Katherine  Hoppes

        2:30  pm     BREAK

        2:45  pm     SEP  Module  -­‐  Hospital  Based  Medicine  -­‐  Part  II

                Sarah  Richards

        3:45  pm     BREAK

        4:00  pm     SEP  Module  -­‐  Hospital  Based  Medicine  -­‐  Part  III

                Abby  Shiffermiller

        5:00  pm       Resident  and  Student  Poster  Compe99on

        6:35  pm     Doctors’  Dilemma

                Devin  Fox

        7:45  pm     Poster  Winners  Announced

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PROGRAM SCHEDULE:

Friday,       7:00  am     Fellowship  Breakfast**

October  18             Registra9on  Con9nues

        8:00  am     Morning  Session  Begins

                Regan  Taylor,  Moderator

        8:00  am     Male  Hormone  Replacement

                Amy  Neumeister

        9:00  am     Obesity  360  Degrees

                Birgit  Khandalawala

        10:00  am     BREAK

        10:30  am     Washington  Update  -­‐  Bob  Doherty

        11:15  am     Fostering  Excellence  &  Professionalism  in

                Internal  Medicine  -­‐  Thomas  Tape

   **Any  member  contemplaNng  applying  for  advancement  to  Fellowship  should  aQend,  as  well  as  current  Fellows  who  can  assist  those  seeking  Fellowship  by  acNng  as  seconders  to  their  applicaNon.

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PROGRAM SCHEDULE:

Friday,       12:00  pm     Awards  Luncheon  &  Town  Hall  MeeNng

October  18               William  Shiffermiller

        1:00  pm     AGernoon  Session  Begins

        1:00  pm     Trans  Catheter  Value  Replacement  Surgery

                Ruby  Satpathy

        2:00  pm     An  Update  in  Hospital  Medicine  2013

                Thomas  Frederickson

        3:00  pm     BREAK

        3:30  pm     Familial  Colon  Cancers  -­‐  Stephen  Lanspa

        4:30  pm     Thieves’  Market  -­‐  J.  Scob  Neumeister

PLANNING COMMITTEE:

William A. Shiffermiller, MD, FACP Regan Taylor, MD, FACP Pallavi Bellamkonda, MD

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FACULTY:Bob   Doherty   is  Senior   Vice  President   of   Governmental  Affairs  and  Public   Policy   for   the  American  College  of   Physicians   (ACP),   the  largest   physician  specialty   society   and   second  largest   medical   organiza9on   in   the   U.S.   ACP   represents   130,000   internal   medicine  physicians  and  medical  students.    Mr.  Doherty  has  over  32  years  of  health  policy  experience  and  is  an  accomplished  presenter  at  health  conferences.    From  1979  to  1998,  he  worked  in  the  governmental  affairs  department   of   the  American  Society   of   Internal  Medicine,   and  with  the  merger  of  ASIM  and  ACP  in  June,  1998,  joined  the  ACP  as  Senior  Vice  President  for  Governmental  Affairs  and  Public  Policy.    

Thomas  W.  Frederickson,  MD,  FACP,  has  been  a  prac9ce  hospitalist  for  15  years,  previously  in  Kansas  City  Missouri,  and  currently   with  Alegent  Creighton  Health.    He  is  currently   the  Medical  Director   for  Hospital  Medicine  at   Alegent  Creighton  Health.    His  clinical  interests  are  hospital  medicine  program   leadership,   pa9ent   safety,   evidence  based   care  and   care  redesign.

Devin   J.  Fox,  MD.   FACP,  grew  up  in  Omaha,   NE,   and  aTended  the  University   of  Nebraska  Medical  Center  for  medical  school  aler   doing  his  undergraduate  work  at  the  University  of  Nebraska   at   Lincoln.     He   did   his   residency   training   and   chief   residency   at   Creighton  University   Medical  Center   in  Omaha.      He  is  a  partner   in  a  community-­‐based  prac9ce  in  Omaha  and   has  stayed  on   as   faculty   at   Creighton,   where  he   is  involved   in   student   and  resident  educa9on  at  various  levels  in  their  training,  and  is  the  course  director  for  the  fourth  year   sub-­‐internship   in   Internal   Medicine.     His   clinical   interests   include   Preventa9ve  Medicine  and  Wellness,  HIV  medicine,  and  Geriatrics.    

Katherine  Hoppes,  MD,   is  originally   from  Omaha,   aTended  college  at   UNL   and  medical  school   at   UNMC.     She   completed   her   Internal   Medicine   Residency   in   2008   and   was  Ambulatory   Chief   Resident.     She  has  worked   as  a  Hospitalist   at   Methodist   Hospital   in  Omaha  since  2009.

Birgit  Khandalavala,  MD,  is  an  obesity  medicine  specialist.    She  has  been  the  director  of  the  medical  division  for  the  Bariatrics  Center  at  the  University  of  Nebraska  Medical  Center  since  June   2012.     Dr.   Khandalavala  completed   her   residency   in   Family   Medicine  at   Creighton  University   and  had  remained  on  faculty  in  the  Department  of  Family  Medicine  at  Creighton  since  1997.    Her   clinical  work  consists  of  obesity  management  and  her   research  interests  include  obesity  bias,  post-­‐bariatric  surgery  outcomes  and  the  use  of  obesity  medica9on.  Her  desire   is   to   see   obesity   recognized   as  a  chronic   disease,   incorporated   into  mainstream  clinical  management  by  every  provider.

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FACULTY:

Stephen   Lanspa,   MD,   FACP,   received   his  Doctorate  of   Medicine   at   Creighton  University  School  of  Medicine  in  Omaha,  Nebraska.  He  was  a  Fellow  in  Internal  Medicine  and  a  Trainee  in  Gastroenterology   at  Mayo  Graduate  School  of  Medicine  in  Rochester,  Minnesota.       He  received  his  Master   Degree  in  Medical  Management   from   Carnegie  Mellon  University   in  PiTsburgh,   Pennsylvania.     He   is   the   Specialty   Care   Medical   Director   for   the   Alegent-­‐Creighton   Clinic,   and   Professor   of   Medicine   and   Associate   Dean   for   Clinical   Affairs   at  Creighton  University   School  of  Medicine.     He  is  Board  cer9fied  in  Internal  Medicine  and  Gastroenterology.      His  special  interest  is  hereditary  colon  cancer  and  Lynch  syndrome  with  substan9al  research,  lectures,  and  publica9ons  on  these  topics.  

J.   ScoQ   Neumeister,   MD,   FACP,   is   an   Associate   Professor   of   Internal   Medicine   at   the  University   of   Nebraska  Medical   Center.     He   is   a   clinician   educator   in   general   internal  medicine  who  also  teaches    courses  in  clinical  reasoning  to  third  and  fourth  year  students.    For  many  years,  he  has  given  the  "Thieves'  Market"  presenta9ons  at  the  Nebraska  Chapter  ACP  mee9ngs.

Sarah   Richards,   MD,   received   her   MD   degree   from   the  University   of   Nebraska  Medical  Center   (UNMC).    She  completed  her  Internal  Medicine  residency  and  was  a  Chief  Resident  at   UNMC   .     She   currently   serves  as   Co-­‐Director   of   the  Academic   Hospitalists  and   is   a  prac9cing  Hospitalist  at  UNMC.    She  and  her  husband  Blake  have  twin  daughters.

Amy  Neumeister,  MD,  FACP,  grew  up  in  Omaha,  Nebraska.    She  earned  her  Bachelor  of  Arts  in  Music  from  Northwestern  University  before  aTending  the  University  of  Nebraska  Medical  Center  for  medical  school.    She  remained  at  UNMC  for  her  Internal  Medicine  Residency  and  Fellowship.     She  has  been  an  assistant   professor   at   UNMC   in   the  Division   of  Diabetes,  Endocrinology   and  Metabolism  since  2005.     She   is  a  clinician  educator   at   The  Nebraska  Medical  Center’s  Diabetes  Center  and  co-­‐directs  the  endocrine  por9on  of  the  second  year  medical  student  curriculum.    Her  principal  interests  are  diabetes  and  hyperthyroidism.

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FACULTY:

Ruby   Satpathy,   MD,   is   an   Interven9onal  Cardiologist,   who   went   to  William   Beaumont  Hospital,  Michigan  for   Interven9onal  Cardiology   training  aler   finishing  her   residency   and  fellowship  at  Creighton  University.    She  is  one  of  the  very  few  physicians  in  country,  who  are  formally  trained  and  specializes  in  Structural  Heart  Interven9ons.  She  joined  Alegent  Heart  and  Vascular  Ins9tute  in  2010  as  Director  of  Structural  Heart  Program  and  Valve  Clinic.  She  has  been   doing   Transcatheter   Valve  Replacement   since   it   was  FDA   approved   last   year.  Currently  she  serves  on  mul9ple  commiTees  at  na9onal  level  for  ACC  and  SCAI.

Thomas  G.  Tape,  MD.  FACP  is  currently  a  Regent  of  ACP.  He  also  Chairs  the  ACP  Health  and  Public  Policy  CommiTee  and  serves  on  the  High  Value  Care  Task  Force.    During  2012-­‐2013,  he  was  Chair  of  the  Board  of  Governors  and  previous  Governor  for  the  Nebraska  Chapter.  Dr.   Tape   is  a   professor   of   internal  medicine   at   the   University   of   Nebraska   College   of  Medicine,  where  he  serves  as  chief  of  the  division  of  general  internal  medicine  and  vice-­‐chair  of  clinical  affairs  of  the  department  of  internal  Medicine.    Dr.  Tape’s  surveys  of  ACP  physician   members   have   been   published   in   the   Annals   of   Internal   Medicine   and   the  American  Journal  of  Respiratory  and  Cri9cal  Care  Medicine.    He  also  co-­‐edited  an  ACP  book  en9tled,  “Diagnos9c  Strategies  for  Common  Medical  Problems.”  His  research  has  focused  on   beTer   understanding   how   physicians   make   diagnos9c   and   therapeu9c   medical  decisions  with  the  aim  of  improving  the  quality  of  those  decisions.  For  the  past  three  years,  Dr.  Tape  has  served  on  a  medical  center  task  force  to  study  health  care  reform  and  provide  non-­‐par9san  informa9on  to  the  Nebraska  region.

Abby   Shiffermiller,   MD,   is  a  hospitalist   at   Methodist   Hospital   in  Omaha,   in  a  busy   and  constantly   expanding   group.     She  is  beginning  her   filh  year   of  prac9ce  with  Physicians  Clinic.     She  received   her   Internal  Medicine   training   at   The  Nebraska  Medical  Center   in  Omaha  and   completed   her   medical  school   training   there.     She  and   her   husband  both  prac9ce  internal  medicine  in  Omaha  as  hospitalists  in  different   health  systems  and  enjoy  the  medical  community.  

"e reward for work well done $ % o&o'unity to do mor(

--Jonas Salk, MD

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CME ACCREDITATION:

The  American  College  of  Physicians  is  accredited  by  the  Accredita9on  Council  for  Con9nuing  Medical  Educa9on  (ACCME)  to  provide  con9nuing  medical  educa9on  for  physicians.

The  American  College  of  Physicians  designates  this  live  ac9vity   for  a  maximum  of  11  AMA  PRA  Category  1  Credit(s)TM.  Physicians  should  only  claim  credit  commensurate  with  the  extent  of  their  par9cipa9on  in  the  ac9vity.

HOTEL:Hilton  Omaha,  1001  Cass  St.,  Omaha,  NE    68102

Hotel   room  rates:     start   at   $119/night.    All   reservaNons  must   be   received   by  9/17/13.     ATendees  must  iden9fy  themselves  as  being  part  of  American  College  of  Physicians  Conference  to  ensure  the  special  rate.  

ReservaNons:    Please  call  402-­‐998-­‐3400.

HOW TO REGISTER:• If   you   need   more   informa9on   on   the   mee9ng,   please   contact   Kris   Rahm   at   605-­‐339-­‐9804   or  

[email protected]

• RegistraNons  can  be  completed  by  one  of  the  following:

  -­‐Scanning  the  completed  form  and  emailing  to  [email protected]

-­‐Faxing  the  completed  form  to  605-­‐271-­‐9227  (no  cover  sheet  necessary)

-­‐Mailing  the  completed  form  to:     Nebraska  ACP,  4904  S.  Sweetbriar  Dr.,  Sioux  Falls,  SD    57108

• For  informa9on  on  College-­‐related  issues,  contact  the  South  Dakota  Chapter  Governor:  

 William  A.  Shiffermiller,  MD,  [email protected]  (605)  333-­‐6564

• Pre-­‐registraNons  must  be  received  by  October  10th.    Acer  that  date,  you  must  register  on-­‐site  and  there  is  an   addiNonal  $50  fee  —save  money  by  registering  now.       CANCELLATIONS  WITHIN  72  HOURS  OF  OF  THE  MEETING  WILL  BE  CHARGED  FOR  FOOD  AND  CREDIT  CARD  FEES.

• To  access  our  online  mee9ng  informa9on  or  to  print  another  registra9on  form  for  a  friend  or  colleague,  go  to  hTp://www.acponline.org/about_acp/chapters/ne/news_meet.htm

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Pre-­‐registra;ons  must  be  received  by  October  10,  2013.    Cancella;ons  within  72  hours  of  mee;ng  will  be  charged  for  food  and  credit  card  processing  fee.

                                       Nebraska  Fee  Schedule

CHARGE TO: _________________________________________________________ (Name as it appears on card)

_____VISA _____MC _____AMERICAN EXPRESS _____DISCOVER

CARD #_______________________________________________________________

EXP. DATE: ______________________ SECURITY CODE: ___________________ (3 digits on back or 4 digits on front of card)

SIGNATURE:___________________________________________________________

Fee Category

Pre-Registration

On-Site

ACP Member

$165 $215

Non-Member $215 $265

ACP Affiliate Member

$115 $165

Non-Member Affiliate

$175 $225

Resident/Student

No Fee But Must Register

Guest All Meals$100

Awards Only$40

Meals I will attend My guest will attend

Thursday Poster

Session

Friday Breakfast

Friday Awards

Luncheon

Please thoroughly complete this form

Your Name

Guest Name

Credit Card Billing

Address:

City, State, Zip

Email

Phone

Registration Fee

Guest Fee

Voluntary Donation

TOTAL