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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

This year we will be moving to Berlin to hold the conference in the stunning Grand Hyatt Berlin.

If you'd like to book a room at Grand Hyatt Berlin, please contact the hotel's reservations department on +49 (0) 302553 1212 and make a booking in the name of GIRP - Annual Meeting&Conference 2022. Please note that reservations require a valid credit card. It is also possible to book accommodation on the hotel's website using the following group code: G-GIR3. Please book your room by 28 April 2022.

GIRP negotiated rates:
19 - 20 May and 22 - 26 May 2022 : Single room 195 EUR and Double room 215 EUR
20 - 21 May 2022: Single room 275 EUR and Double room 305 EUR

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 2022

PayPal

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

PLEASE FILL IN THIS FORM PRIOR TO 22^ND MAY 2022.

I accept the GIRP event terms and conditions *

Yes

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International bank transfer

PayPal

PLEASE FILL IN THIS FORM PRIOR TO 22ND MAY 2022.

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PLEASE FILL IN THIS FORM PRIOR TO 22^ND MAY 2022.