Capita Selecta Duikgeneeskunde AMC: 2e Mini-Congress Diving Medicine 6 – 13 May 2017
Capita Selecta Duikgeneeskunde
2e Mini-Congress Diving Medicine: Red Sea, Marsa Shagra
Fees
The course, lasting a week and offered by the CSD-AMC, carries these fees:
Meeting FeesPhysician € 375,- / Accreditation fees: NVD / € 45,-
NVAB / € 95,-
Non-Physician € 225,- / VSG / € 45,-
NICDA / € 45,-
Else 1) / € 45,-
1) Education outside own field
Included are: syllabus, course certificate and hot drinks offered during breaks in the proceedings
These fees are based on the organising costs of the mini congress by the CSD.
Due to the many advance payments CSD has to make, we are compelled to make the course fees forfeit.
Travel and accommodation costs 2) 3) As of 1 November 2016
Hotel and Flight
o 7 nights, all inclusive (incl. soft beverages)
o Direct flights Schiphol/Marsa Alem return
o Inclusive: transfers from and to airport Marsa Alem, hand luggage, airport tax; fuel surcharge; airport transfer.
o Exclusive: baggage; travel-, diving- and cancelling insurance; visa fee ($25,- to be paid on arrival).
Double room(per person), € / Single room, €
Chalet 4) / 840 / 984
Chalet de Luxe / 875 / 1019
Hotel only
o 7 nights, all inclusive (incl. soft beverages)
Double room(per person), € / Single room, €
Chalet 4) / 420 / 564
Chalet de Luxe / 455 / 599
2) Depending on availability. The above (provisional) prizes are based on the current prices. Any moment they
can be subjected to change. Early booking limits this chance.
3) The dive-tour operator has a regulation for cancelling (ANVR), a bankruptcy insurance (SGR) and
calamity coverage (Calamiteiten Fonds)
4) Chalet: electric fan. Chalet de Luxe: airco and fridge.
Only registering for the mini-congress (no hotel, no flight): fee according to the table “Meeting Fees”
Booking fee: € 30,- per person
Diving package: 5 days, € 140,- per person
Included: unlimited diving at house reef & 2 guided house reef-dives (depending on experience etc. (first day); Zodiac rides to outer reef; tanks; air; lead.
Not included: transport to official dive sites; Marine Park Tax ca.3 US$/day; € 7 Hyperbaric Chamber coverage.
Registration form
Please fill out identically as mentioned in your passport! / Please fill out electronicallyFirst name
Surname
Male/Female
Date of birth
Street and house number
Postal code and City
Country
E-mail address
Telephone
Cell phone
Telephone (ice)
Specialisation*
Affiliation*
BIG number*
Accreditation
NVAB € 95 * / Yes/No
NVD € 45 * / Yes/No
VSG € 45 * / Yes/No
Education outside own field € 45 * / Yes/No
NICDA € 45 * / Yes/No
Are you sharing a room with another course member? / Yes/No
If so, with whom? This participant needs to fill out his/her own form.
Are you sharing your room with someone who is not participating in the course? / Yes/No
All fields must be completed except for those marked with * when one is not a physician
Registration form for a introduced roommate** (non-course member)
Please fill out the same as mentioned in your passport! / Please fill out electronicallyFirst name
Surname
Male/Female
Date of birth
Name of roommate ( who is a course participant)
E-mail address
**Introduced guest in a separate room? Please fill out a separate form.
Registration form continued
Please complete this calculation electronically
Participant
Booking fee € 30,-
Course fee €
Accreditation add-on(s) €
Travel accommodation packet: €
Business class: prices on request by CSD €
Roommate (non-participant)
Booking fee €
Travel & accommodation packet: same as participant €
Business class: prices on request by CSD €
+
Total Sum (add) €
I agree to the conditions and the total amount due and I agree to pay an advance of € 600 for participating physicians, € 450 for all other participants and € 250 for non-participants, due immediately and the remainder as soon as you receive our invoice.
NB the course participant signs for his/her roommate as well, if this person is a non- participant.
After 1 March 2017 the total sum is immediately due. Be aware that after 1 March 2017 prices could be significantly higher than mentioned here.
Date………………………....Name ……………………………………………
(Electronic) Signature: ………………………………………………..
· Please send this form to:
o electronically to Eduard van Riet Paap, .
· Payments to:
o ING account NL05INGB0005856014 of the Stichting Duik Research at Aerdenhout, the Netherlands under the mention of ‘Marsa Shagra’. BIC code (SWIFT code) of the ING Bank is INGBNL2A.
Conditions
All bookings occur under the conditions of the Dutch ANVR: (http://www.anvr.nl/_upload/NewsFiles/ANVRbrochure2014spread.pdf) for the total amount with the exception of the course and accreditation fees, as these are forfeit.
· Flight and room reservations are made on a basis of availability
· All changes in prices and exchange rates of, but not excluded to, airlines, hotel, governments etc. will be charged until the moment full payment is received.
· In case of cancellation within 7 days after date of signature of this registration form, full restitution will be made except for the booking fee. Cancellations must be made by registered mail addressed to N.A.M. Schellart (BMP&E, bouwdeel L-0, AMC. Postbus 22660, 1100 DD, Amsterdam.). After 7 days, cancelation is in accordance with ANVR regulations.
· This offer is subject to the jurisdiction of the courts of the Netherlands.
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