LGD Alliance Europe » Register now!

Register now!

Please fill in the form below and click on Submit to register for the conference. Registration closes at November 5th 2016.

Email *
Phone number Please provide your mobile phone number so we can contact you during the conference if needed.

1. First and last name
Relationship to patient
Is the attendee a child or an adult?
2. First and last name
Relationship to patient
Is the attendee a child or an adult?
3. First and last name
Relationship to patient
Is the attendee a child or an adult?
4. First and last name
Relationship to patient
Is the attendee a child or an adult?
5. First and last name
Relationship to patient
Is the attendee a child or an adult?
Registration fee There will be a € 20,00 registration fee for adults (18 and older) to be paid during registration on Saturday.

CMTC will book your room(s) for you based on your answers in this form. You pay the hotel at check-out. *
Are you staying overnight at the hotel?Yes, 1 night from Friday onto SaturdayYes, 1 night from Saturday onto SundayYes, 2 nights from Friday onto SundayNo
If yes, for how many persons per room?
Need an extra room? For how many persons per room?
Comments
If you have any requests or remarks concerning the rooms, leave your reply here (i.e. baby cot).

Will you join us for dinner on Saturday evening? *
Join us for a typical pancake dinner at an old farm nearby. € 17,00 for adults and €10,00 for children 12 and younger, including drinks.YesNo
If yes How many adults?
How many children (12 or younger)?

LGDA
If you have any questions you would like to get answered at this conference, please ask them here.