Implant Marathon Online Registration

To secure your spot, please complete all of the information below and follow the link on the next page to submit your deposit payment.

First Name:

Last Name:

Date of birth:

Company

Shipping address:

City:

State:

Zip code:

Country:

Telephone:

Mobile No:

Email:

Name for your Certificate:

AGD #:

Specialty:

Location:

Date:

Level:

I learned about this course by:

Promo/Referral Code

Current Implant Experience

By signing and submitting your registration, you agree to the Implant Marathon terms and conditions.

To reserve your spot, we must receive the following:

  • Completed and Signed Registration Form
  • Deposit of $1,000 USD

Required documents:

  • Deposit of $1,000USD is non-refundable but can be transferred to another course date for up to 1 year.
  • Course discounts are non-transferable unless the same discount is offered for the new date of your choosing.
  • Tuition must be paid off no later than 4 weeks before the course begins
  • Course dates are subject to change, with prior notice from Implantology Courses Inc
  • In the case of a course cancellation or postponement made by Implantology Courses Inc, the participant has the option to withdraw from the program and receive a refund, or transfer their tuition to another course date.
  • In the case of cancellation of attendance by the participant (must be made in writing), the following will apply:
  • 6+ weeks prior to course: tuition refund minus deposit
  • 4-6 weeks prior to course: tuition refund minus 25% fee (includes deposit)
  • 4 weeks and less: tuition is non-refundable/tuition credit can be transferred to another course for up to 1 year. Additional hotel fees may apply if the hotel reservations have been finalized.

Payment and Cancellation Policy:

  • All cancellations must be made in writing, no later than 4 weeks prior to the original course date. Tution is non-refundable after the 4 week mark, but can be transferred to another course date. Postponing course less than 10 days before arrival may incur a hotel and clinic fee.
  • Deposit of $1,000 USD is NON REFUNDABLE but can be transferred for up to 1 year.
  • Payments are due no later than 4 weeks prior to course, or upon registration, whichever comes first
  • Course dates are subject to change with prior notice from the organizer.

In Case of Emergency

List any medical condition we should be aware of

Emergency contact name

Emergency contact phone

Emergency contact relation

Payment

To secure your spot, a deposit of $1,000USD must be paid via a secure online link, which will be provided upon submission of your online registration. The remaining tuition balance will be due no later than 4 weeks before the course begins and your course confirmation email will outline a payment due date.

Signature

(With my Signature I confirm, that I accept the Implant Marathon General Terms & Conditions)

Date:

Implantology Courses | 710 W Higgins Rd Suite 102, Park Ridge, IL 60068 | Tel: 877-705-1002 | Fax: 630-705-1003 | [email protected]

A deposit of $1,000USD is required upon registration and spot reservation. The remaining tuition balance is due no later than 4 weeks before the session begins. Your course confirmation email will outline your payment due date.

We offer referral, early-bird, and recent grad discounts. Alternatively, you may finance your tuition for up to 12 months interest free.

  1. Level 1 (implant placement): To attend our Level 1 course, you must have a valid dental license and proof of graduation/diploma. General dentistry knowledge is required, and basic theoretical Implantology knowledge is recommended.
  2. Level 2 (sinus lifts) : To attend our Level 2 course, you must have placed a minimum of 50 implants, or completed our Level 1 course.
  3. Level 3: To attend our Level 3 course, you must have extensive practical implantology and oral surgery experience, with placement of 200 implants, and completion of our Level 2 course.

Registration is only valid once a $1,000 deposit has been received. Once your spot is reserved, you will receive a confirmation email with all further details.

The course must be paid off in full before the course start date by:
  1. Full payment (credit card, check, wire transfer)
  2. In-house payment plan
  3. Lending Club Financing (interest free and extended plans available)
The following documents will need to be submitted by email to our course coordinator, a few weeks before the course begins:
  1. Passport (copy or clear photo)
  2. Valid Dental License or Registration  (copy or clear photo)
  3. Dental Diploma (copy or clear photo)
  4. Resume
  5. Infectious Disease Medical Results (depending on location)
Please find a full list of our terms and conditions on our registration form.
 
Initial course deposits are non-refundable but can be transferred to a further course date with no penalty.
Course cancellations must be made in writing and submitted by certified mail, no later than 4 weeks prior to course date.
Last minute cancellations or course date transfers may be subject to penalty fees.