Registration form 64th annual conference German-English Medical Association / Anglo-German Medical SocietyStratford 5-8 September 2024 "*" indicates required fields Questions from the hotel, answer required for booking!(also for participants who are not staying at the Crown Plaza)Name* First name Surname Email address* Allergies?* Yes No Allergies, dietary preferences*(vegetarian, gluten-free, etc.) How severe is the allergy?*(Scale 1-10)12345678910Is the allergy aerogenic?* Yes No AccommodationI am organising accommodation myself Yes No I am staying at the Crown PlazaNote: guests at the Crown Plaza do NOT need to book their room themselves. The hotel asked us to provide a group booking. Yes No Date of arrival* DD slash MM slash YYYY Date of departure* DD slash MM slash YYYY Room* Single room Double room together with Name of the accompanying person Participation in the annual conferenceGet together at The Dirty Duck*Thursday, 05.09.2024 Food and drinks NOT included Yes No Sightseeing programme Stratford*Friday, 06.09.2024Guided tours, entrance fees, and dinner (without drinks) included in the price for the whole conference, lunch not included Yes No Scientific programme*Saturday, 07.09.2024Break snacks and lunch (without alcoholic beverages) included in the price Yes No Annual Dinner*Saturday, 07.09.2024Completely included in the price Yes No individual departure*Sunday, 08.09.2024 Yes No Cost for the participation in the Annual Meeting, incl. stay at Crown Plaza for 1 person per room (breakfast included): £500Cost for the participation in the Annual Meeting, incl. stay at Crown Plaza for 2 people in a double room (breakfast included): £695Cost for the participation in the Annual Meeting, without stay at Crown Plaza: £165Cost for the participation in the Annual Meeting, only on Saturday, 07.09 incl. Annual Dinner: £125Cost for the participation in the Annual Meeting, only on Saturday, 07.09, scientific programme only: £80Cost for annual dinner only (for guests/spouses): £42Please pay the conference fee by Aug 1st: Account Name Account: ANGLO-GERMAN MEDICAL SOCIETY Type: Community A/C Account Number: 53741029 Sort Code: 23-05-80 IBAN: GB76MYMB23058053741029PhoneThis field is for validation purposes and should be left unchanged.
