Logistics arrangements - SEUD Masterclass - December 6th and 7th

Family name*

First name*

Date of birth*

E-mail

Cell phone number*

Accommodation

Paris Marriott Opera Ambassador Hotel*

Night of December 5th (5th to 6th, day before the congress) = FREE
Night of December 6th (6th to 7th) = FREE
Night of December 7th (7th to 8th) = 220€
I don't need accommodation

Single room, breakfast included. The organizing committee covers a maximum of 2 nights. The extra and added night (220€) will be charged to you (and has to be paid upon arrival). If you need a double room (20$ surcharge/night), please keep us informed in the last part of this form "Special requests".

Transport

Yes, I would like you to make my travel arrangements
No, I will make my own travel arrangements

Departure city*

Departure date*

Departure time*

: Heure

Minutes

Return city (if it is not departure city)

Return date*

Return time*

: Heure

Minutes

Membership card type and number (airline, railroad company...)

Download your passport or ID Card*

Types de fichiers acceptés : jpeg, jpg, png, pdf, gif, Taille max. des fichiers : 128 MB.

Essential to book your travel. Thanks.

Social Program

Faculty Dinner - December 6th 2019*

Yes, I take part to the dinner
I will be accompanied by one person (60€)
No, I do not take part to the dinner

Miscellaneous

Special Requests

GDPR*

I certify that I am a healthcare professional.

GDPR*

By clicking on 'Send', I confirm that I have read and understood our Privacy Policy and consent to the processing of my personal data by COM&CO EVENTS, in accordance with the said Policy, in order to best respond to my registration request.

I authorize that my personal data be transmitted to the industrial partners participating in the event, for exclusively professional purposes.

Name

Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

Logistics arrangements – SEUD Masterclass – December 6th and 7th