Hosted Team Pass Submissions

A team member has offered you an opportunity to join them as a Hosted Agent at Medicarians Vegas. Please complete the following form to apply for a complimentary pass.

Please note: The Hosted Agent Program is reserved for Licensed Agents who serve clients directly. Completing this form does not guarantee your pass. All submissions are reviewed and approved by the Medicarians team. For new registrations only. No refunds for prior purchases.

First name *

Last name *

Email Address *

Company *

Website URL *

Job Title *

Your NPN

Your LinkedIn

Physical Address (GDPR Compliance)? *

Would you like to apply for Hosted Agent Plus for $395?*

* Upgrade your Medicarians experience with a $395 Hosted Agent Plus Pass. Select 'Please Add Me' Below if interested.

Includes All Benefits of Hosted Agent Pass, plus:

Exclusive Lounge with Refreshments
Priority Registration Desk
Private Networking Function
Dedicated On-Site Help
Extended Access to Video Playback

No ThanksYes, Please Add Me

I understand that if I am selected as a Hosted Agent, I will be required
to join at least one sponsored session of my choice.
Note: The list of participating sponsored sessions will be shared with me
by show management three to four weeks from Medicarians Vegas 2026.*

YesNo

Any Comments or Questions?

Hosted Team Pass Submissions

Would you like to apply for Hosted Agent Plus for $395?*

I understand that if I am selected as a Hosted Agent, I will be required to join at least one sponsored session of my choice. Note: The list of participating sponsored sessions will be shared with me by show management three to four weeks from Medicarians Vegas 2026.*

I understand that if I am selected as a Hosted Agent, I will be required
to join at least one sponsored session of my choice.
Note: The list of participating sponsored sessions will be shared with me
by show management three to four weeks from Medicarians Vegas 2026.*