Your Registration

Online Registration is only for new attendees; if you are an existing member please register through Empire's member portal.


Botulinum Toxin Training	$1,299.00 Memorial Day Discount Applied remove
Aug 22 2020 Costa Mesa / Orange County, CA Hotel to be announced

Joint / Extremity / Non-Spinal Injection Course	$999.00 Memorial Day Discount Applied remove
Jun 27 2020 Empire-Virtual-Training LiveStream / Online Training

Botulinum Toxin Training	$1,299.00 Memorial Day Discount Applied remove
May 08 2021 Orlando, FL Hilton Orlando Lake Buena Vista

Cosmetic Laser Courses and Certification	$1,299.00 Memorial Day Discount Applied remove
Jul 10 2021 -Jul 11 2021 New York City, NY New York Marriott at the Brooklyn Bridge

Anti-Aging (Modules I & II)	$699.00 Memorial Day Discount Applied remove
Dec 12 2020 Empire-Virtual-Training LiveStream / Online Training

Advanced Botox and Dermal Fillers (Level II)	$1,299.00 Memorial Day Discount Applied remove
Sep 12 2021 Austin, TX The Westin Austin Downtown

Botulinum Toxin Training	$1,399.00 Memorial Day Discount Applied remove
Apr 09 2022 Las Vegas, NV The Platinum Hotel & Spa

Joint / Extremity / Non-Spinal Injection Course	$1,299.00 Memorial Day Discount Applied remove
Aug 13 2022 New York City, NY Graduate Roosevelt Island Hotel

Complete Dermal Filler Training	$1,499.00 Memorial Day Discount Applied remove
Oct 22 2022 Denver, CO Doubletree by Hilton Denver Tech Center

Sub-Total: $11,091.00
(-) Discount: $200.00
Clear Cart discount / vendor code codes cannot be combined. Use only one per order. Total Amount Due: $10,891.00

1 - Customer Information

First Name:

Last Name:

Medical Title:

Email Address:

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Are you a Practice Owner?:

Medical State License #:

Name of Account Rep who guided you, if any:

Would you bring your own model?: (if applicable)

Would you like to participate as a model for others?: (if applicable)

2 - Payment Information

eCheck Payment

CONSUMER AUTHORIZATION FOR DIRECT DEPOSIT VIA ACH

I (we) hereby authorize EMPIRE MEDICAL TRAINING, INC to electronically debit my account as follows at the depository financial institution named below. I (we) agree that ACH transactions that I (we) authorize comply with all applicable law.

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I (we) understand that this authorization will remain in full force and effect until I (we) notify EMPIRE MEDICAL TRAINING, INC. in writing at the following:

Empire Medical Training, Inc.
2720 East Oakland Park Blvd, #102
Fort Lauderdale, FL 33306
(954) 525-4273
(954) 358-2860 (F)

That I (we) wish to revoke this authorization.

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3 - Billing Information

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I acknowledge that I have read and agree with the Empire Medical Training terms of service, privacy policy, and cookie policy. California courses attendees: In order to inject during hands-on sessions, you need to be licensed to inject in California.