Registration form

Please fill all required fields marked with *

Personal data
 
 
Profession *
 
 
 
 
 
Invoice data
 
 
 
 
 
 
Assistants (with physician)

You can book for your assistants
Please fill in the name and last name for each person

 
Gala dinner

It is possibile to make reservation for the gala dinner on Friday, June 5th at a cost of 100 € (VAT included) per person

 
Choose payment method

Total amount due: € 0

Notes