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Aerospace Medical Association &
Undersea and Hyperbaric Medical Society

Registration Opens On January 1, 2026

Individual Registration

Please enter information in the form below to complete your registration for 2026 AsMA-UHMS Exhibit Space Registration.

THIS FORM IS FOR CREDIT CARD PAYMENTS ONLY - registration & checks must be mailed to: The HERLITZ COMPANY 108 Montgomery Street, Suite 205 • Rhinebeck, NY; payable in U.S. dollars and drawn on a U.S. bank to: Aerospace Medical Association


Important: We are accepting full payment or a deposit of $1,100.00 (Non Profit/Scientific booth deposit is $1,100.00) for each booth requested. If you pay a deposit, you agree to pay the balance by MARCH 20, 2026 via submittal of this form.


Payment Information

Coupon
Amount
$
Discount Amount
$
Gross Amount
$
Payment Type
Payment Method
Bluepay
Credit Card Number*
Expiration Date*
/
Card (CVV) Code*
Card Holder Name*