BSRM Registration 48th Scientific Meeting

Registration form - 48th BSRM Scientific Meeting

Friday and Saturday, 25-26 November 2022
Bruges Meeting & Convention Centre, Beursplein 1, 8000 Brugge

Identification details

First Name*

Last Name*

Title

Institute

Department

Street - number*

Zip code*

City*

Country

VAT Number

RIZIV-number

Format: 11234512340

Email*

Date of birth

Date

Language

Profession*

Registration

We have availability in 3 hotels in the city center of Bruges. Prices are equal for the hotels.

- Crowne Plaza Brugge, Burg 10, 8000 Bruges - Fully booked
- Martin's Brugge, Oude Burg 5, 8000 Bruges - Fully booked
Both hotels are located within 15 minutes walking distance from the meeting venue.
Dinner venue: Crowne Plaza Brugge
Martin's Brugge is located 2 minutes walking distance from Crowne Plaza (dinner venue).

- Hotel NH Bruges, Boeveriestraat 2, 8000 Bruges
This hotel is located within 3 minutes walking distance from the meeting venue. And within 12 minutes from Crowne Plaza (dinner venue).

Late registration fee from 14 November 2022.

Only paid-up BSRM members can attend the scientific meeting.

Hotel

Hotel NH Bruges

DINNER FULLY BOOKED

Registration overview

273 Euro - Single room (night of 25 November) + Scientific Meeting (1 person) + Late registration fee of €20 inclusive204 Euro per person - 2 persons: Shared double room (night of 25 November) + 1 Scientific Meeting + Late registration fee of €20 inclusive105 Euro - Scientific meeting only + Late registration fee of €20 inclusive188 Euro - Single room - Hotel only + Late registration fee of €20 inclusive218 Euro - Double room - Hotel only + Late registration fee of €20 inclusive

Name of person with whom you will share a room

Membership fee 2022

75 Euro - Clinicians / Biologists40 Euro - Paramedicals / residents in training

Total

Special meal requests

Remarks

Payment method

Bank transferVisa / Mastercard

Credit card

EURPay

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Payment policy

Full payment has to be made to the BSRM account • IBAN number: BE79 3101 2631 7833 • BIC: BBRUBEBB • Bank: ING, with reference: “Name + 48th Scientific Meeting”. Upon receipt of your payment, your room (including breakfast) will be booked and guaranteed and you will receive a confirmation. As of 30 October, rooms will be booked upon availability in the hotel. All extras during your stay in the hotel such as minibar, telephone charges, room service, other bar costs, etc must be paid directly to the hotel when checking out.

Cancellation policy

Your payment will be refunded provided a written cancellation is received by the BSRM Central Office before October 1, 2022. 70% of your payment will be refunded if a written cancellation is received after October 1 and before October 30, 2022. Please note that there will be no refund for the cancellations received after October 30, 2022.

Please verify that you are human*