Register To Compete!

Reach out for event details or partnership questions

Competitor

Competitor Identity

First & Last Name(Required)

First Last

Preferred Name (Badge)

Professional License Number(Required)

Issuing State/Region & Country(Required)

State / Province / Region Country

License Expiration Date(Required)

Email Address(Required)

Enter Email Confirm Email

Phone Number(Required)

Business & Insurance

Practice or Business Name(Required)

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Professional Liability Carrier(Required)

Policy Number(Required)

Policy Expiration Date(Required)

Upload Certificate of Insurance(Required)

Max. file size: 1 GB.

Prescribing/Supervision

Do you require a supervising/prescribing physician?(Required)

Yes

Prescriber Name(Required)

First Last

Prescriber Phone Number(Required)

Prescriber Email Address(Required)

Prescriber Issuing State/Region & Country(Required)

State / Province / Region Country

Prescriber License Number(Required)

Competition Details

Competition Category

Natural Lip

Advanced Lip

Full Facial Contour

Male Facial Enhancement

1 category is included in the competitor price, additional categories are $300/ea

Experience Level(Required)

Brief Bio(Required)

Please confirm that you will bring the required supplies for your participation.(Required)

I will bring 4 vials of Hyaluronidase for the competition.

I need the emergency package, which includes the necessary materials to compete. ($300)

Model Linkage

Will you bring your own model or need a match?(Required)

Bring

Need match

Model Full Name (Must Complete Model Form)(Required)

Preferred Characteristics/Contraindications(Required)

Safety & Adverse Events

BLS or ACLS(Required)

Max. file size: 1 GB.

Consents & Releases

COMPETITOR LIABILITY WAIVER — AMERICA’S NEXT TOP INJECTOR™

Competitor Liability Waiver & Release of Responsibility

This Competitor Liability Waiver and Release of Responsibility (“Agreement”) is entered into by and between America’s Next Top Injector, LLC (“ANTI,” “Event Organizer”), a Maryland limited liability company, and the undersigned licensed medical provider (“Competitor”). By signing this Agreement, Competitor acknowledges, understands, and agrees to the following terms:

1. Licensure Requirements

Competitor affirms they hold an active, unrestricted license to practice as a medical provider authorized to perform cosmetic injectable procedures in:

the State of Maryland, or
a Compact State recognized under the Nurse Licensure Compact (NLC) or Interstate Medical Licensure Compact (IMLC),

Nurse Licensure Compact (NLC) States:
AL, AZ, AR, CO, DE, FL, GA, ID, IN, IA, KS, KY, LA, ME, MD, MS, MO, MT, NE, NH, NJ, NM, NC, ND, OH, OK, SC, SD, TN, TX, UT, VA, WV, WI, WY

Interstate Medical Licensure Compact (IMLC) States:
AL, AZ, CO, GA, ID, IL, IA, KS, KY, ME, MD, MI, MN, MS, MT, NE, NV, NH, ND, OH, OK, PA, SD, TN, TX, UT, VT, WA, WV, WI, WY

Competitor agrees to provide proof of licensure to ANTI no later than 90 days prior to the Event. Failure to comply will result in disqualification.

2. Professional Responsibility & Patient Care

Competitor acknowledges and agrees that all models are considered their patients for the purposes of the Event. Competitor assumes full clinical responsibility for the safety, care, and well-being of any models they treat, including:

obtaining and documenting informed consent,
providing appropriate patient education and aftercare instructions,
ensuring compliance with all applicable standards of care.

ANTI shall not be held liable for any claim of negligence, malpractice, or injury arising from Competitor’s actions or omissions.

3. Models

Competitor agrees to provide their own models for the Event. If unable to secure models, Competitor must notify ANTI in writing at least 90 days before the Event so that reasonable accommodations may be discussed. Failure to comply may result in disqualification.

4. Medical Malpractice Insurance

Competitor must maintain current medical malpractice insurance that covers injectable aesthetic procedures in Maryland. Proof of insurance must be submitted to ANTI no later than 90 days prior to the Event. Competitor agrees that ANTI is not responsible for providing or covering malpractice insurance on their behalf.

5. Supplies & Clinical Space

ANTI will provide all necessary supplies, equipment, and clinical space required for participation on the day of the competition. Competitor agrees to use supplies and facilities responsibly and in compliance with all applicable laws and safety standards.

6. Release of Liability

To the fullest extent permitted by Maryland law, Competitor hereby releases, waives, and forever discharges ANTI, its officers, members, employees, contractors, sponsors, and affiliates from any and all claims, demands, causes of action, damages, costs, or liability of any kind related to or arising from Competitor’s participation in the Event. This includes but is not limited to claims of malpractice, negligence, bodily injury, emotional distress, or property damage associated with Competitor’s medical treatment of models.

7. Governing Law & Venue

This Agreement shall be governed by and construed in accordance with the laws of the State of Maryland, without regard to conflict of laws principles. Any dispute shall be subject to the exclusive jurisdiction of the state and federal courts located in Howard County, Maryland.

8. Severability

If any provision of this Agreement is found to be invalid or unenforceable under Maryland law, the remaining provisions shall remain in full force and effect.

9. Entire Agreement

This Agreement constitutes the entire understanding between Competitor and ANTI regarding participation and supersedes all prior agreements, oral or written.

America’s Next Top Injector, LLC (ANTI) — Maryland, USA
Version: 2026-01-23 • Event: Baltimore, MD

Signature(Required)

Payment

Without payment, you will not be able to enter the competition.

Thank you for registering! Please complete payment below:

Pay Now

Payment(Required)

I have paid using the above link.