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SFL Forum 2015

Registration form


All fields marked with * must be filled in.

Participant
Title
First name/s*:
Surname / Family name*:
birthdate*:
Institute / company*:
Profession:
Phone*:
E-mail*:
Billing address
Institute / company
Street*:
City*:
ZIP*:
Country*:
ID No.:
VAT ID No:
Accompanying person
Title
Name
Surname
Registration fees *
Registration Fees by February 23, 2015
SFL Country Champions Free*
Affiliate SFL country Country Champions Free registration**
SFL Project Managers Free*
Affiliate SFL country Project Managers Free registration**
SFL Executive Committee Members Free*
SFL Faculty & Speaker Free*
Government Representatives, EU & EHN guest Free*
SFL Forum participant invited by SFL country Free registration**
SFL Industry Partners*** Free registration**
NGO Category (non-government organizations) € 60
Physicians € 90
Industry Representatives € 200
 

* “Free” category includes: free registration for the conference, reimbursement for the air ticket costs (limitations apply), free accommodation in Lindner
Hotel Prague Castle (single room, category Standard, including breakfast).
** “Free registration” includes: free registration for the conference.

***
  • Platinum: 5 seats
  • Gold: 3 seats
  • Silver: 2 seats
  • Bronze: 1 seat

Accommodation reservation
Lindner Hotel Prague Castle ****
Type of roomPrice (per person and night)No. of persons
Single Business € 90
Double Business € 55

note

Date of arrival Date of departure

All beds must be paid for in the multi-bed rooms. Therefore, always state the name of your roommate. If the names are not mentioned, all beds in the room will be charged automatically

Social programme
Date Price No. of persons
Gala dinner 27.2. - Invited 27th February 2015 € 0
Gala dinner 27.2. 27th February 2015 € 36
Comment
Payment conditions

All prices given are in EUR (€). Kindly pay the respective amount in accordance with the Payment Order which will be issued and sent to you upon the delivery of your registration and hotel booking form. The payment is regulated by the general conditions and deadlines stated below.
All payments must be net of all charges; all bank charges applied during the payment of the registration fee, reserved accommodation, or other services reserved through this form are to be paid by the payer.

In case of credit card payment, the bank Komerční banka charges an extra fee amounting to 3% of the total amount.

No cheques are accepted.

Payment by credit card*
Card type*
No of CC*
Expiration date of CC*
CVV/CVC code*
Holder's name*

CVV/CVC code is the 3 or 4 digit number located on the back of the VISA/MC card.
Wire transfer *

Declaration

By submitting this form I express my acknowledgement and accept the conditions and rules applied for registration, participation, hotel accommodation, payments, and also the general conditions and cancellation conditions set for the STENT FOR LIFE SFL Forum 2015. I also authorise Congress Prague as the professional meeting organizer to use the data indicated in this form for further electronic processing for the purposes of the meeting.

Participants, whose registration fees, accommodation or other services are already covered in full from SFL congress budget, shall mark the field "wire transfer". It is not possible to send the on-line form without selecting a type of payment; your order then will be processed and you will receive confirmation and won't be charged.

By submitting the registration form (or by sending a completed and signed printed registration form including its scan copy), you hereby consent to Congress Prague, s.r.o .:

  • processing and handling of personal data contained in this registration form solely for the purpose of registration at this educational event, sending further information about this educational event and possibly other educational events organized by Congress Prague, s.r.o.,
  • the solution and settlement of other related orders related to your participation in this educational event or other educational events organized by Congress Prague, s.r.o.,
  • settlement of payments, inquiries and suggestions related to your participation in this event and other educational events organized by Congress Prague, s.r.o.

All this within and under the law of the Personal Data Protection Act No. 101/2000 Coll. as amended, and the General Data Protection Regulation (GDPR), in its entirety: Regulation EU 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of individuals with regard to the processing of personal data.
You may revoke this consent at any time, the appeal must be in writing and must be addressed and delivered to Congress Prague, s.r.o. The withdrawal of consent takes effect the next day after delivery. You acknowledge that the effectiveness of revoking your consent does not relieve you of your responsibility for fulfilling your obligations, obligations and paying for payments for properly ordered services under this registration form and other valid orders at Congress Prague, s.r.o.
In case of proper filling in and sending of the form you will receive an automatic confirmation by e-mail. If you do not receive such confirmation, please contact the organizer of this event directly office(zavinac)congressprague.cz.

Upon submitting the form successfully, you will be notified through an automatically generated e-mail sent to your e-mail address. In case no such confirmation is delivered, please contact directly the event organizer (office@congressprague.cz).