International Hip Society 2021 closed meeting
Berlin, Germany
November 3 - 6, 2021
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First name *
Last name *
Name of accompanying person
Date of birth - accompany person
MM
/
DD
/
YYYY
E-mail address IHS member *
Work phone
Mobile phone *
E-mail address assistant/secretary *
Please let us know if you and/or your accompany person have any special dietary needs or requests
I will ... *
Yes
No
... attend reception Wednesday
... attend program Thursday
... attend dinner Thursday
... attend program Friday
... attend tour Berlin Friday afternoon
... attend dinner Friday
... attend program Saturday
Accompanying person will ...
Yes
No
... attend reception Wednesday
... attend day tour incl lunch Thursday
... attend dinner Thursday
... attend lunch Friday at hotel
...attend tour Berlin Friday afternoon
... attend dinner Friday
... attend lunch at hotel Saturday
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Pricing
Fee for scientific meeting: USD 150
Fee for accompany person: USD 150

Hotel reservation at Hotel-de-Rome is done directly to the hotel - see information.
Important!
After you have submitted the form - please go to pay by using the PayPal button or
send a check drawn on IHS on the amount above + USD 40 to:
Kajsa Erikson
IHS, c/o Orthopaedics, R-huset floor 4
Sahlgrenska University Hospital/Molndal
SE-431 80 Molndal
Sweden

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