Bookings

Job Title*

Hospital*

Organisation

Contact Address*

Contact Email*

Please be aware some workplace accounts (including NHS email) will not accept emails from our system, if possible, please provide an alternative email address.

All emails will be copied to this address.

Contact Telephone*

Membership Status*

Membership Status

Membership/Participant No.

Membership/Participant No.*

Event Attendance

Please tick all of the days of the event you wish to attend:

FULL - Please contact us to be put on the waiting list FULL - Please contact us to be put on the waiting list

The price to book the full event is £

Event Attendance

Attendee Quantity*

s Meeting Options s Workshops

()

Speaker:

Description:

FULL

Not Attending

I am bringing a guest
Number of Additional Guests (Max. )

Dietary Requirements

Parking

Accommodation

General Notes

How Did You Hear About This Event?

Payment*

Total Booking Cost

£

I have read and accept the privacy policy

Event Registration

()

£