8th Meeting of the ICI-RS

14 – 16 June 2018

Watershed Media Centre, Bristol, UK

REGISTRATION FORM

REGISTRATION FEES

As for previous ICI-RS meetings, and in order to keep administrative costs to the minimum, we have a very simple (but rigid) registration system!

£100 which, if you register before 14th May 2018, includes your accommodation but ONLY at the Ibis hotel).

Please don’t forget to add payment for the cost of your guest’s dinners

NOTE; IF YOU REGISTER AFTER 14th MAY YOU MAY HAVE TO ARRANGE ACCOMMODATION AT YOUR OWN EXPENSE.

ICI-RS policy is that members attend for all 3 days of the meeting, and therefore there is no daily rate

Please complete the form below and the payment details overleaf and return this form by email to

FULL NAME (please print clearly)
TITLE (Prof/Mr/Mrs/Miss/Ms/Dr/etc.)

Are you a member? Yes /No

If not a member, please confirm that you have applied for membership YES

Hospital/Institution address

EMAIL TEL (include code)
MOBILE/CELLPHONE number FAX (include code)

This is a 3 day meeting and we would encourage delegates to attend the whole event. If for some reason you are unable to come for 3 days then please indicate below clearly which days you are able to attend.

Please Select: I will be attending on 14th / 15th / 16thJune(please  as appropriate)

Accommodation

Please book hotel accommodation at the Ibis Hotel on: 13th / 14th / 15th / 16thJune

(please  as appropriate)

**Please note that we will only offer accommodation on the 16th June to those delegatesfor whom there are no flights home after the end of the meeting on Saturday,for example, those who are attending from North America.**

Or, please do not book hotel accommodation for me; I shall arrange my own accommodation:

I shall be accompanied enter NAME of guest

I wish to attend the dinners on [these are included in the delegate registration fee]

(please  all that apply and select the number of places required:

14th June no. of places required 15th June no. of places required

Please note: You will need to add a payment for your guest(s) attending any of the dinners at a cost of: £40 for 14th June and £45for 15th June.

Special dietary requirements, if appropriate, e.g. vegetarian:

PAYMENT DETAILS

Payment should be made by debit/credit card (NOT American Express). If you want to pay by other means please contact Kirsten Klevmark(EMAIL BELOW)

VISA MASTERCARD SWITCHMAESTRO
(Please note we regret we cannot accept payment from American Express and Visa Electron)

Card Number:
Security code (last three digits on the back of the card):
Valid from date / Expiry date: / Issue Number (if applicable)

Name on Card:

Full address to which card is registered (including postcode)

Amount to be debited: £

(in pounds sterling)

Please complete this form and return it by email to: