Registration Form

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Contact Phone Number (Mobile):

Hospital: Position Held:

Workshop Choice

Option 1 I wish to attend the workshop day on 4th of October’ 19

I wish to give following preferences (Please number your preferences 1 to 4)

Please note : There are 4 workshops conducted; out of which any delegate could choose only two in the following combinations. Please write your preference in front of each paired combination of workshops, i.e. 1st to 4th preference.

Whilst every attempt would be made to accommodate the request of 1st and 2nd preferences; due to the ceiling on number of delegates per workshop, this cannot be guaranteed. The usual criteria of 'first come; first served' would be applied.

Enter the relevant number 1 to 4 in the boxes below:

Airway + CPET
Ultrasound in Critical care + Airway
CPET + Ultrasound in Regional Anaesthesia
Ultrasound in Regional Anaesthesia + Ultrasound in Critical Care

I have following experience with CPET:

No experience / training
Some experience
Considerable experience

(Kindly note that the above information re. your knowledge about CPET would enable us to put you in the suitable group whilst attending the CPET Workshop. It does not affect your chances of getting the CPET Workshop).

Workshop Choice

Option 2

I wish to attend the Scientific Programme on Saturday, the 5th of October’19 and the Saturday evening Dance & Banquet Indian Dinner

View details of Scientific Programme

Workshop Choice

Option 3

I wish to attend both the days (4th & 5th of October’19) ; along with the Saturday evening Dance & Banquet Indian Dinner on 5th of October’19

View details of Scientific Programme
I have given my preferences for workshops.

Option 4

I wish to attend the workshop day on 4th of October’19 and the Saturday evening Dance & Banquet Indian Dinner on 5th of October’19

Anaesthesia Associates, ODPS and Nurses

Guests

Getting the Guests (Spouses, Partners and/or Friends) for the Bollywood Night & Dinner: £ 40.00 per guest.

Number of guests:

Getting the Kids for the Bollywood Night & Dinner: £ 20.00 per guest.

(Kids with age 5 and 12 years)

Number of guests (Kids):

Special Dietary Requirements

I have following dietary requirements: I have following food allergies: My guests have following dietary requirements: My guests have following food allergies:

Conference Fees

Annual Scientific Meeting (Covers the full day at the ASM and the Bollywood Night)

• Early Bird Offer till 25th of September = £ 220
• After 25th of September = £ 250.00

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Annual Scientific Meeting [ Trainee/ Non Consultant ] (Covers the full day at the ASM and the Bollywood Night)

• Early Bird Offer till 25th of September = £ 200
• After 25th of September = £ 220.00

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Annual Scientific Meeting [ Anaesthetisia Associates/ ODPs and Nurses ] (Covers the full day at the ASM and the Bollywood Night)

• £ 70

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Guests (Spouses, Partners and/or Friends) for the Bollywood Night & Dinner

• Early Bird Offer till 25th of September = £ 40.00
• After 25th of September = £ 60.00

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Kids (Age 5 Years to 12 Years) for the Bollywood Night & Dinner

• £ 20.00

Cancellation Policy

50% refund of fees till 15th September,2022. The refund would be processed after the Event completion. Processing refunds can take 4 weeks time. Refund payments will be made through BACS.

After 15th of September, there would not be any refund of the fees.

Calculate Fee

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