Registration

Registration is accepted according to the 'first come, first served' principle.
Early bird rate of 275 euros incl. VAT when registering before May 15th, 2024.
After May 15th, 2024, the registration fee is 325 euros incl. VAT. Participation is only possible for the two days.
Hotel stay must be arranged by participants.

Gender:		Mrs.     Mr.
Title:
Name/Initials:
Prefix:
Surname:
Country:
Phone number (+country code):
E-mail address:
Specialism:
You are:		physician fellow in training
Hospital:
City:
Country:
BIG code:
Payment method:		Electronic banking (iDeal, MasterCard, Visa, American Express, Pay Pal and more)   (this is the only payment method)
		Debit (SEPA, Single Euro Payments Area)
Ascription:  Address:  Postal code:  City:  Country:  IBAN number:    You can enter your IBAN number above. BIC code:        Select a bank for your BIC code. If unavailable you need to bring your complete BIC code.
Permission required due to General Data Protection Regulation (GDPR) Agree that we process your data in accordance with our Privacy Statement and Sponsor Policy. It is mandatory to fill in this box: otherwise we will unfortunately not be able to register you.
Question (optional):
(Fields that are marked with a   are mandatory fields)