AXISMEDIX SUMMIT

Sponsorship Registration & Payment Form

Translating Conference Discoveries into Community Relevance

Date: Feb 14, 2025

Name
example@example.com
Please Enter a Valid phone number.
Company Address

Corporate Level Sponsorship Packages

1. Pioneer Sponsor
2. Advocate Sponsor

Add-On Programs *

IMPACT-1
IMPACT-2
REACH
ADVISORY BOARD
NEWSLETTER
Drag & Drop Files, Choose Files to Upload

Payments

Mail Payment To:

Axismedix, LLC
1222 Du Motier Drive
Ballwin, MO 63011

Tax ID No: 39-2275761

Cell: 573-529-5884

Email: info@axismedix.com

Payment Terms
Payment Terms Credit card payments may be accepted on a case-by-case basis and are subject to a 3% processing fee. To request an invoice, please contact info@axismedix.com
Acknowledgement
By signing below, I confirm that I am an authorized representative of the Sponsor listed above and have the legal authority to enter into this agreement. This application will constitute a binding contract upon the Sponsor’s authorized signature and acceptance by AxisMedix
Cancellation Policy
If the AxisMedix Summit is cancelled or rescheduled by the organizers for any reason, the Sponsor may, within sixty (60) days of receiving written notice, elect to:
(a) Apply the sponsorship payment toward the rescheduled event or revised format;
(b) request a refund of sponsorship fees paid, less a pro rata deduction for any conference-related expenses already incurred by AxisMedix.
If the Sponsor cancels its participation for any reason, all sponsorship payments shall be considered non-refundable.
Clear Signature
Sign Here