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Participant

Title *

Dr.

First name *

Last name *

Organisation/Company *

Function *

Address *

City *

ZIP code *

Country *

Email address *

Telephone number *

Arrival date *

Month

Day

Year

Departure date *

Month

Day

Year

Spouse

Title

Dr.

First name

Last name

Special requirements

Please indicate below any special requirements you have (i.e. disabled access, late arrival, dietary requirements, etc.)

Translation

Will you require translation facilities?

Yes

If so, please indicate the language for which you will need translation*

* Please note that translation facilities will only be provided for a MINIMUM of 10 delegates requiring a particular language, but cannot be supplied on an individual basis.

Accommodation

*BOOK YOUR DISCOUNTED RATE NOW*

We're pleased to share that GIRP has secured exclusive discounted rates for conference attendees at the opulent Prague Marriott Hotel. To make the most of this special offer, we invite you to secure your accommodations by reserving your room through our dedicated booking link: https://www.marriott.com/event-reservations/reservation-link.mi?id=17010...

Immerse yourself in the rich history and culture of Prague while enjoying the unparalleled comfort and amenities provided by the Prague Marriott Hotel. Don't miss out on this unique opportunity to combine business with pleasure!

Registration Fee

The conference registration fee includes participation in the social programmes but excludes travel and accommodation.

Fees *

Member only rate - 2150 €

Member and accompanying person rate - 2550 €

Non-member only rate - 2450 €

Non-member and accompanying person rate - 2850 €

VAT Number*

* Should you need your organisation's VAT Number featured on the participation invoice, please indicate the number here above.

Registration fees have to be settled prior to the conference by:

International bank transfer

Please make your bank transfer payable to GIRP, bank account number N° 210-0831484-52 at the BNP Paribas Fortis Bank, Place Andrée Payfa-Fosseprez 7, 1170 Watermael-Boitsfort, Belgium.
BIC: GEBABE BB
IBAN: BE64 2100 8314 8452
Reference: Participant’s Name and Surname, GIRP AMC 2023

PayPal

In this case please provide the email address where we can send the payment request.

PLEASE FILL IN THIS FORM PRIOR TO 24^TH MAY 2024.

I accept the GIRP event terms and conditions *

Yes

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International bank transfer

PayPal

PLEASE FILL IN THIS FORM PRIOR TO 24TH MAY 2024.

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PLEASE FILL IN THIS FORM PRIOR TO 24^TH MAY 2024.