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Please fill out the following form to RSVP for the ISA Day at the Statehouse.

The event will take place Monday, January 22, 2024 (10:00 am - 3:00 pm ET). Please note: you do not need to be in attendance the entire time and may come anytime during that time frame, but we do anticipate peak attendance to be between 11:00 am and 1:00 pm.

Lunch will be available on a first come, first served basis.

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* 1. Insert Name:

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* 3. Liability Waiver

By clicking “I AGREE” below, you are acknowledging that an inherent risk of exposure to Coronavirus ("COVID-19") exists in any public place where people are present.

By attending the event hosted by the Indiana Society of Anesthesiologists ("ISA"), you and any guests voluntarily assume all risks related to exposure to COVID-19 and agree not to hold ISA, or any of their affiliates, directors, officers, employees, agents, contractors, or volunteers liable for any illness or injury.

Furthermore, by clicking "I AGREE" below, you agree to abide by all applicable COVID-19-related requirements, advisories, policies, procedures, and protocols of the venue and ISA, as well as the Centers for Disease Control and Prevention (CDC), the State of Indiana, and any other governmental authority for the duration of the event.

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PLEASE NOTE: All attendees must agree to this waiver prior to arriving onsite.

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