Registration

Title
Dr.Mr.Mrs.Ms.Miss
Name *

Email *

Phone *

Address *

Name of the Dental Practice you own

General Dental PracticeSpecialist Dental Practice

Are you bringing a guest? (practice owners can bring 1 non-owner guest)
YesNo

Payment Details (There is no credit card surcharge)

Card No.
Exp:

CCV

Terms & Conditions:

Topics and speakers are subject to change without notice. The organisers will make every effort to ensure the event will take place as advertised. However, the organisers do not take financial responsibility to changes or disruptions that may occur as a result of events beyond their control. The organisers reserve the right to cancel the event at any time with no responsibility to the participants other than a full refund of registration fees.
Refunds for cancellations will only be provided before the 16th of April 2019 and these will incur an administration fee equivalent to 10% of the conference fee. No refunds for cancellations will be provided following the 16th of April 2019. The organising committee may refuse registration to any individual.

Yes,I understand the terms and conditions.