I would like to register the following number of participants as follows:

Early-bird registration (by 12 May 2014):

0123456789 x Member rate (€725) - 0123456789 x Non-Member rate (€799) - 0123456789 x Partner rate (€315)

Standard registration (after 12 May 2014):

0123456789 x Member rate (€775) - 0123456789 x Non-Member rate (€849) - 0123456789 x Partner rate (€365)

Hotel Accommodation

Two nights' accommodation in a double room (single occupancy for participants / double occupancy for participants with partner) and breakfast are included in the congress registration fee. Additional nights (€ 147,00 single occupancy / 164,00 double occupancy) and upgrades to an executive room (€ 40,00 per night) are paid by participants direct to the hotel, together with any extras.

Date of arrival: - Date of departure:

Please book an upgrade to an executive room for the following participants:

Please provide the following number of participants with vegetarian meals:

x Vegetarian (including fish)

x Vegetarian (not including fish)

I have the following request/special requirement:

Name of Participant:

Email of Participant:

Mobile phone number of Participant:

Name of Partner (not attending conference):

Company:

Address (only required for non-members, include zip and city):

Country:

I wish to register the above for the Summer Congress

* Name:

* Email:

* Date:

[ A copy of this form will be sent to you by e-mail. ]