Please Return This Form Bye-Mail, Fax Or by Mail To

PLEASE RETURN THIS FORM BYE-MAIL, FAX OR BY MAIL TO:

MCI Suisse SA, Official Registration and Housing Bureau

On behalf of IOF Regionals - 1stLatin America Osteoporosis Meeting

Rue de Lyon 75 –CH-1211 Geneva - Switzerland

Tel:+41(0)22 33 99 594 -Fax:+41 (0)223399631- E-mail:

MEDIA REGISTRATIONFORM (please fill in CAPITAL letters)

Prof/Dr/Mrs/Mr/Ms/Other: First Name: Family Name:

Institution / Company:

Mailing Address:

Postal Code: City: Country:

Telephone Country Code: Area Code: Number:

Fax Country Code: Area Code: Number:

E-mail:

Profiling of Registrant

Print Newspaper
Print Magazine
On-line / Television
Radio
Photographer / Other

Profiling of Organisation/Employer

Government/Public
NGO / Private
Free Lance / Other

Special Needs

It is important to us that you enjoy the IOF Regionals - 1stLatin America Osteoporosis Meeting. If, due to a disability, you have any special needs, please let us know and we will do our best to assist you. Please specify: / Yes No

Registration Fees

Please tick the appropriate box

Categories / Apply before May 24
Media Registration* / Free

*In order to benefit from the Media free registration, you will have to send your credentials.

For further information, please refer to the information available online at

Mediaregistration fee includes: / The registration fee does not include:
Admission to all Plenary Sessions, Meet-the-Expert Sessions, Satellite Symposia, Poster Sessions and Exhibition Area
One copy of the Final Programme & Abstract Book
A bag containing official material and a Meeting badge
A certificate of attendance
Coffee breaks & lunches
Opening Ceremony & Welcome Cocktail / Airport transfers
Local transportation to the Meeting venue
Other meals & drinks
Accommodation
Excursions
Insurance & visa fees

Please confirm your participation for:

Opening Ceremony & Welcome Reception, Thursday May 24, 2012

First evening, a reception is organized for participants, registered accompanying persons and exhibitors

Meet-the-Expert (against space availability)

One per Session: Please tick the appropriate box(es)

Friday May 25, 2012 – 08:00 – 08:50

DXA LSC in Clinical Setting (Fidencio Cons Molina / Mexico)

Indications for the Use of Anabolic Agents (Hector Gajardo, Chile)

Biochemical Markers: Are they ready and which to use? (Marise Lazaretti Castro/Brazil)

VFA: Indications and Interpretation (Casimiro Velazco/Dominican Republic)

Strategies to prevent falls and fractures (Jaime Hernandez, Uruguay)

Saturday May 26, 2012 – 08:00 – 08:50

DXA LSC in Clinical Setting (Fidencio Cons Molina / Mexico)

Indications for the Use of Anabolic Agents (Hector Gajardo, Chile)

Biochemical Markers: Are they ready and which to use? (Marise Lazaretti Castro / Brazil)

VFA: Indications and Interpretation (Casimiro Velazco/ Dominican Republic)

Strategies to prevent falls and fractures (Jaime Hernandez, Uruguay)

Hotel Accommodation (optional)

For your reservation, please fill in this form and return it not later than March 15, 2012. As hotel accommodation is subject to availability, requests received after this date will not be guaranteed.Reservations are made on a first-come, first-served basis. Availability of rooms in each category is limited. Name of persons sharing rooms must be indicated. All rates are quoted in United States Dollars (USD), per room, per night, and include breakfast, city tax and ISS tax. The rate of exchange between the Brazilian Real (BRL) and United States Dollar (USD) was set in February of 2012. Exchange rates can fluctuate substantially and as such any significant variation of the exchange rate may lead to a retroactive increase/decrease in the specific hotel rate as expressed in USD.Rates apply for standard room; other room types like deluxe room, junior suite, suite, etc. are available upon request.

Only guaranteed reservations will be accepted. To guarantee your reservation a payment covering the full stay is required. Additional expenses such as mini-bar and telephone must be paid directly to the hotel when checking out. From April 15, 2012 only payment made by credit card will be accepted.

Group reservations will be handled by MCI Suisse SA with separate contracts.

Please indicate your choice of hotels in order of preference (one form per registrant)

Reference / Hotel / Rank / Location / Single
Occupancy / Double
Occupancy
A / Grand Hyatt São Paulo / 5-Star / Connected to the venue / 394.00 USD / 452.00 USD
B / Hilton São Paulo Mrumbi / 5-Star / No longer available
C / Gran Estanplaza / 4-Star Sup / 5’ driving distance
10’ walking distance / 292.00 USD / 326.00 USD
D / Novotel Morumbi / 4-Star / 5’ driving distance
15’ walking distance / 239.00 USD / 266.00 USD
E / Tryp Berrini / 3-Star Sup / 5’ driving distance
15’ walking distance / 183.00 USD / 242.00 USD
256.00 USD / 315.00 USD
F / Blue Tree Berrini / 3-star / No longer available
1stchoice: 2ndchoice: 3rdchoice: / Arrival date:
 Single room  Double room  Twin room (2 beds) / Departure date:
Sharing with:
First Name Family Name / Number of nights:

TOTAL DUE (C)USD

TOTAL DUEUSD

First Name: Family Name:

Conditions of payment for hotel bookings (Please tick the appropriate box)

Payments: All hotel bookings must be paid in advance in United StatesDollars (USD) payable to MCI Suisse SA,on behalf of IOF Regionals - 1st Latin America Osteoporosis Meeting - 75 rue de Lyon, CH-1211 Geneva 13, Switzerland.

No confirmation will be sent until MCI Suisse SA has received the payment.

By bank transfer, in United StatesDollars (USD) made payable to:

MCI Suisse SARue de Lyon 75 - CH-1211 Geneva 13, Switzerland

Bank Name/Address:UBS SA - 35 rue des Noirettes - CH-1227 Carouge, Switzerland

Account Number UBS USD:240-369.393.61X

Clearing:240

IBAN:CH19 0024 0240 3693 9361X

SWIFT/BIC: UBSWCHZH80A

Please indicate your first and family name, your registration number (mentioned on the registration invoice), and "1st IOF Latin America Osteoporosis Meeting".

All costs are to be borne by the ordering customer and please mention "free of charge for the receiver account" on all payments.

By credit card. I authorise MCI Suisse SA to charge my credit card for the total amount indicated above:

 Eurocard /MasterCard  Visa American Express

Cardholder's name: Card number:

Expiry date: Security code(CVC)*:

Signature and date:

*CVC: Your card security code is a three or four digit number. For Visa and Eurocard, the code is the last three digits printed on the signature strip on the back of the card. For American express, the code is the four digits printed on the front of the card.

From April 15, 2012, only payment by credit cardis accepted.

Confirmation of Registration and Hotel Booking

Upon receipt of your duly completed registration form, we will issue and send you the invoice (for hotel only) corresponding to the registration and service(s) (subject to availability) requested.

Your registration will be confirmed only once your credentials have been sent and approved to:

Media Agency

Tino Comunicação – Brasil

Rua Gunha Gago, 700 – Pinheiros / 12° andar, 122

São Paulo – Cep: 05421-001, Brazil

Office +55 11 3170-3137

Mobile +55 11 7492-8040

Maria SimõesVinicius Volpi

Tel: +55 11 7422-3182 Tel:+55 11 7492-8040

No hotel booking will be confirmed until the full invoice is paid.

Please present your confirmation letter at the Registration Desk in order to obtain meeting documentation and badge.

Remember to state participant name and MCI Suisse SA - 1st IOF Latin America Osteoporosis Meeting as well as your invoice or registration number on all payments.

First Name: Family Name:

Payments, Cancellation and Refunds

Cancellations and changes to your original registrations including hotel bookings must be made in writing to MCI Suisse SA by email at r by fax at +41 (0)22 33 99 631 – Please see conditions below:

Payment conditions

• Hotels

Important: To guarantee your reservation a payment covering the full stay is required.Additional expenses such as mini-bar and telephone must be paid directly to the hotel when checking out. From April 15, only payment by credit card will be accepted.

Cancellation, Modifications and Refund Policy

• Registration, Social Events and Excursions

Notification of cancellation and refund requests must be submitted in writing, preferably by e-mail, by May 14, 2012to the Official Registration and Housing Bureau(MCI Suisse SA) at the contact details listed below.

• Individual Badge Name Changes (Substitution of Registration)

An administrative fee of USD 55 per badge will be charged for a badge name change after May 15, 2012. Written permission from the original participant will be required, along with full contact details of the media substitution.

• Hotels

All changes to hotel reservations will be handled by MCI Suisse SA. Please do not contact the hotel directly.

A handling fee of USD 55per hotel room will be charged for every hotel modification received after March 15, 2012.

All cancellations must be sent to MCI in writing (fax, letter, or e-mail).

For cancellations received before March 15, 2012, deposits will be refunded less USD 100 for administrative costs. After this date, no refund will be possible.

In case of late cancellations (after March 15, 2011), cancelled rooms, cancelled nights or no-show, we reserve the right to charge the full stay if the hotel room can not be re-sold.

Liability and Insurance

The Meeting Organizer (IOF), the Meeting Venue (Grand Hyatt São Paulo), its official appointed Registration & Housing Bureau (MCI Suisse SA) and Exhibition & Sponsorship Agency (MCI Brasil S/A) and any suppliers, representatives or agents linked to the organization of the Meeting shall not be held liable by any person for any injury, damage, theft, loss, medical problem or inconvenience which may be suffered by any person while traveling to or from, or during such person’s presence in São Paulo in connection with this Meeting. Participants and their guests are advised to purchase their own insurance against any such occurrences.

Cancellation or Modification of the Meeting due to Force Majeure

In case of force majeure, the Meeting organizers have the right to alter or cancel the Meeting without prior notice, however a notice of the occurrence shall be given by IOF as soon as reasonably possible. Force majeure shall mean any circumstance beyond the reasonable control of IOF which prevents or impedes the holding of the Meeting, including, but not limited to, government action, war or hostilities, riot or civil commotion, plague or other epidemic such as SARS, bird flu, etc, earthquake, flood, hurricane, tsunami, cyclone, fire or other natural physical disaster, explosion, accident or breakdown, strike, lack of the usual means of transportation or terrorism or due to events which are not attributable to wrongful intent or gross negligence of the IOF. IOF shall not be liable for any direct or indirect, incidental or consequential damages, losses, expenditures or any other inconveniences or costs caused by such modification or cancellation of the Meeting. Furthermore, registration fees will not be reimbursed by IOF.

Force Majeure for Hotel Accommodation

MCI Suisse SA and the Hotel(s) are not responsible for either the partial or total non-execution of the contract in the event of accident, an act caused by a third party, or in case of major force such as: special measures taken by the government or local authorities, total or partial strike, lockout, fire, threats to public safety including terrorism, war, health hazards, natural disasters, flood, or some other comparable events or disaster which prevents the Hotel(s) from accommodating the clients of MCI Suisse SA for the event or if for the same reasons the event is cancelled by MCI Suisse SA.

Disclaimer

All reasonable endeavors will be made to hold the Meeting and to present its programme as scheduled under circumstances which assure the comfort and safety of all participants and their guests. However, the IOF reserves the right to modify the programme, unilaterally and without notice.

Neither IOF, nor their officers, directors, employees, representatives or agents, shall be held liable by any person as a result of the cancellation of the Meeting or any of the arrangements, programs or plans connected therewith, or for any injury, damage or inconvenience which may be suffered by any person while travelling to or from, or during such person’s presence in São Paulo, Brazil in connection with this Meeting. Participants and their guests are advised to purchase their own insurance against any such occurrences.

Any litigation stemming from the above contract will be tried in Nyon, Switzerland where the Swiss law is exclusively applicable.

Remember to make a copy of this form for your own files.

First Name: Family Name: Signature: Date:

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IOF Regionals – Brazil 2012_MEDIA Registration & Accommodation Form V1 15/04/12