Tangerine Events Ltd
PO Box 31598, Milford
Northshore, Auckland

Registration Form

Please fill out the online registration form below.

Alternatively download, print and fax your registration:

Gastro 2010 Registration Form

Delegate details
Title
First name*
Surname*  
Company/Organisation*
Position*
Postal address*
City*
Country*
Postcode*
Telephone*
Mobile*
Fax
Email*

Namebadge*

Please enter your name as it should appear on your badge

Special requirements
Privacy

The Privacy Act 1993 provides that your name and contact details cannot be published in the list of conference delegates for distribution to to fellow delegates, exhibitors or any other party without your consent.

I DO NOT wish for my name and details to be included in the list of participants.
Registration Fees*

Early Bird fees prior to September 30, 2010:
Full Registration  

 
NZSG Member   $820.00
NZSG Non-Member   $870.00
Registrar Package (includes dinner)   $810.00
Nurse (includes Dinner)   $531.50
Health Professional   $531.50
One Day Registration  

 
NZSG Member   $480.50
NZSG Non-Member   $531.50
Registrar   $380.00
Nurse   $301.50
Health Professional   $301.50
Half Day Registration  

 
NZSG Member   $240.50
NZSG Non-Member   $266.00
RACP - YIA   $190.00
Registrar   $190.00
Nurse   $151.50
Health Professional   $151.50
Registration Fees Subtotal: (incl GST) $0.00

*** If ONE DAY or HALF DAY registration, please specify attending:

Wednesday Thursday Friday
Half Day Only:
Morning Afternoon  
Workshops
These workshops are included in the registration fees. Please indicate your attendance at these workshops for seating and catering purposes.
Wednesday
Nurses - IBD Workshop
10:15 - 15:20
Nurses - Hepititis Workshop
13:00 - 15:00
Nurses - PEG Workshop
13:00 - 15:00
Thursday
Nurses AGM - Breakfast Meeting
07:00 - 08:15
Pillcam Breakfast Meeting (medical only)
07:00 - 08:15
IBD Breakfast Meeting
07:00 - 08:15
Social Functions
If you are a Nurse or Registrar where the Conference Dinner is included in your registration fee, you MUST select Yes if you wish to attend the dinner.  If you have selected No you will not be issued with a ticket and will be unable to attend.  If you have selected No and have changed your mind and wish to attend, please contact the organiser within 7 days of the conference.
Welcome Function: Wednesday 17 November, 5.30pm*

Included in FULL delegate registration fee.

YES, I wish to attend the Welcome Function
NO, I do not wish to attend the Welcome Function
Number of Welcome Function Tickets: @ $57.50ea
Nurses Dinner:
Wednesday 17 November, 7.00pm*

(NURSES ONLY) Costs are covered by the sponsors. Additional tickets are not available

YES, I wish to attend the Nurses Dinner
NO, I do not wish to attend the Nurses Dinner

NZSG Doctors Dinner:
Wednesday 17 November, 7.00pm*

(NZSG MEMBERS ONLY) Costs are covered by the sponsors. Additional tickets are not available

YES, I wish to attend the NZSG Doctors Dinner
NO, I do not wish to attend the NZSG Doctors Dinner

Conference Dinner:
Thursday 18 November, 7.30pm*

Costs are not included in the registration fee except for full nurses or registrar registration only

YES, I AM A NURSE or REGISTRAR and wish to attend the Conference Dinner
YES, I wish to attend the Conference Dinner (others)
NO, I do not wish to attend the Conference Dinner

Conference Dinner Tickets: @ $125.00ea
Social Functions Subtotal: $0.00
Accommodation

Accommodation Bookings have now closed.

Payment
Method of Payment*
Cheque: Cheques in NZ$ payable to Gastro Conference 2010
Direct Credit: 03 0181 0228716-01, Gastro Conference 2010

Invoice: Please invoice my organisation, refer Order No:

Credit Card:** You will be requested to process payment on submission of this form

**VISA and MASTERCARD Only. AMEX is not accepted.
Payment Summary
Registration Fees: $0.00
Social Functions: $0.00
Total: (incl GST) $0.00
 
Cancellation Policy

Should you be unable to attend, a substitute is always welcome at no extra charge. Please notify the Registration Administrator in writing. A full refund, less an administration charge of 10%, is given for cancellations received in writing by 30th September 2010. After this date, any refunds will be given at the discretion of the Organising Committee. If the Organising Committee has to cancel the conference, in circumstances beyond their control, all registration fees will be refunded in full.

I have read and understand the Cancellation Policy*
Submit Registration

Please check all details before submitting your registration.

I have checked the details of my registration and confirm all are correct

If you have selected to pay by CREDIT CARD you will automatically be
directed to a secure Payments Page to complete your transaction.