ECM 2017 Registration form
Payment via Bank transfer: Your registration will be only confirmed once the payment arrived to our bank account. Please transfer the price of the ticket you choose below.
Date of birth
Prefer not to say
Please indicate the city of your local chapter
Please choose the ticket you would like to buy
Normal ticket: 220 euro --> Gives you access to the full conference
Weekend ticket: 145 euros --> Gives you access to the opening ceremony and full weekend activity (gala, workshops, brunch)
Only gala dinner: 95.72 euros --> Gives you access only to the attend the Superheroes Gala
Your expected arrival time?
Thursday lunch and Pre - programme
Thursday evening - Opening ceremony
Do you require home hospitality? (The places are limited and are available on a first come first served basis. We will confirm this to you in the coming weeks)
Your expected departure time?
Sunday morning before the closing
Emergency contact person (name and phone number of a family member or friend we can contact in case of emergency during the event) *
Send me a copy of my responses.
Please complete the captcha before submitting the form.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service