Registration Form for Pharmaceutical Companies, Postgraduate Students, Speakers, Voluntary Sector Organisation and Other Professionals

Main Group Contact

Contact Details (if not attending the event)

Primary Address

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Group Members

Please select the ticket type required below. This applies for the first person only, you will have the option to select the ticket types for other group members afterwards.

2 Day Tickets (Friday & Saturday)

AMOUNT
1,100.00
TOTAL
AMOUNT
350.00
TOTAL
AMOUNT
150.00
TOTAL
AMOUNT
100.00
TOTAL

Friday Only Tickets

AMOUNT
1,100.00
TOTAL
AMOUNT
350.00
TOTAL
AMOUNT
150.00
TOTAL
AMOUNT
100.00
TOTAL

Saturday Only Tickets

AMOUNT
1,100.00
TOTAL
AMOUNT
350.00
TOTAL
AMOUNT
150.00
TOTAL
AMOUNT
100.00
TOTAL

Contact Details

Primary Address

Please note, your full name and dietary requirement if provided will be shared with the Jurys Inn Hinckley Island for the purpose of delivering this event.

I agree to share my first and last name on the delegate list

If you would like to add dinner for Friday 11th November, please select this below

AMOUNT
30.00
TOTAL

Contact Details

Primary Address

Please note, your full name and dietary requirement if provided will be shared with the Jurys Inn Hinckley Island for the purpose of delivering this event.

I agree to share my first and last name on the delegate list

If you would like to add dinner for Friday 11th November, please select this below

AMOUNT
0.00
TOTAL
AMOUNT
0.00
TOTAL

Do you require accommodation for the Conference? Please specify below:

If you require an accessible room please book this by emailing adconference@actionduchenne.org. 

Summary

Terms and Conditions

Payment

Thank you for Registering to attend the Action Duchenne International Conference. You will shortly receive a booking confirmation to your email. Should this not arrive please contact adconference@conferencecare.com or call 44 2476 369747  for assistance. 

Don’t forget to book your accommodation if it is needed. The venue is offering hotel rooms at the special Action Duchenne rate. There are also alternative local hotel options. Please click here to view the accommodation options.

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