Registration Form - Foreign Delegates

Welcome to the online registration for the 1^st International Perinatal TOTAL Health Congress!

To register for the event, please follow the registration steps below:

1. Personal data
2. Registration categories
3. Cancellations & Refunds
4. Billing information
5. Summary page
6. Payment
7. Registration confirmation

Before you start, please note:
• Fields marked with * are mandatory and must be filled in before finalizing your form.
• Changes can be made on the Summary page once your registration has been completed.
• Click on the

sign for more detailed information regarding a particular field.
• After submitting your online form, you will receive an automatic confirmation email with the details of your registration.
A more detailed registration confirmation will be emailed to you within the next 5 working days.

Step 1 - Contact Details

Salutation

Title

First Name

Last Name

Organization/Hospital

Department

Email Address

Mobile No.

Address

City

State/County/District

Country

Profession/Specialty

Please select one of the options available below.

Profession/Specialty

Data Processing Consent

I authorize Ralcom Exhibitions to use my contact details (first & last name, e-mail address, affiliation, personal identification number) to register me as a participant for the 1st International Perinatal TOTAL Health Congress, to send me information regarding my attendance to the event (by e-mail, phone or post office) and send my details to third parties (CME providers, national and international authorized accreditation institutions) so that my certificate of accreditation is issued.

I do not authorize Ralcom Exhibitions to use my contact details (first & last name, e-mail address, affiliation, personal identification number) to register me as a participant for the 1st International Perinatal TOTAL Health Congress, to send me information regarding my attendance to the event (by e-mail, phone or post office) and send my details to third parties (CME providers, national and international authorized accreditation institutions) so that my certificate of accreditation is issued.

Marketing Privacy

I authorize Ralcom Exhibitions to use my contact details (first & last name, e-mail, phone number, postal address) for research and/or statistics purposes or for other marketing campaigns regarding the medical events organized by Ralcom Exhibitions or any of its scientific partners.

I do not authorize Ralcom Exhibitions to use my contact details (first & last name, e-mail, phone number, postal address) for research and/or statistics purposes or for other marketing campaigns regarding the medical events organized by Ralcom Exhibitions or any of its scientific partners.

Please select the appropriate registration category from the list below.

NOTE
The Organizing Committee is pleased to inform you that physicians contributing to the scientific program will benefit of discounted registration fees, as follows:
✓ Chairmen and speakers contributing to a symposium/workshop will benefit of a 30% discount from the standard registration fee.
✓ All presenting authors of oral presentations/e-Posters/new research will benefit of a 20% discount from the standard registration fee.
.
To take advantage of the discount, after selecting your registration category, write down your discount code:
✓ For workshop/symposium speakers & chairmen the discount code is SESSION
✓ For oral presentations/e-Posters/new research presenting authors the discount code is PRESENT

The participants’ registration fee includes:
(1) Participation in the scientific events of the Congress; (2) Access to the e-Posters’ area; (3) The Congress’ materials (name badge, bag, the Congress Final Program Brochure and abstracts CD); (4) Access to the specialized medical exhibition; (5) Participation to the Welcome Networking Reception; (7) Participation to coffee breaks; (7) Document of participation.

The students’ registration fee includes:
(1) Participation to the scientific events of the Congress; (2) Access to the e-Posters’ area; (3) Name badge; (4) Access to the specialized medical exhibition; (5) Participation to coffee breaks; (6) Document of participation.

Note:
The Organizers are obligated to provide the bag containing the Congress’ materials only for the participants registered until 31 May 2018.
For participants registered after this date, the bag containing the Congress’ materials will be distributed according to the stock availability.

In case of attendance cancellation, all refunds shall be made according to the specifications below. The refund shall be made in maximum 30 days after the closing of the Congress.

✔ Registration cancellation until 01 April 2018:
The Organizers will withhold the amount of 50 EURO (VAT included) / participant from the registration fee.

✔ Registration cancellation starting with 02 April 2018:
There will be no refunding of the registration fee.

Participant’s replacement
✔ The Organizers will charge 50 EURO per participant, excepting students.
✔ Deadline for participant’s change or replacement: 15 May 2018; after this date, no other changes / replacements will be accepted.
✔ The registered participant will send a written notification to the Congress Secretariat, Ralcom Exhibitions, via e-mail at registration@perinatal2018international.org or by fax at: +40-21-212 72 02.

What type of invoice do you need for your payment?

Organization/Payer Name

VAT Number

Bank Name & Bank Account no.

SWIFT Code

Address

City

District/County/State

Country

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Registration Form - Foreign Delegates

Data Processing Consent

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