Registration form
You are registering for the Rural Health & Family Physicians Joint Congress 2026
Attendee information
Your details that will be used for the CPD certificates and name tags.
Name (as it will appear on your nametag)
*
First Name
Last Name
Name (as it should appear on your CPD certificate)
First Name
Last Name
Title [e.g,. Mr, Ms, Mrs, Dr Prof, etc.]
AffiliationDistrict
*
Profession
*
District
Professional Council Registration Number [HPCSA/ SANC)
*
MP/SANC/PS/OT/PT etc.
Email
*
example@example.com
Sector
*
Public
Private
Academic
Student
Registrar
NGO
Other
Province
*
Eastern Cape
Free State
Gauteng
KwaZulu Natal
Limpopo
Mpumalanga
North West
Northern Cape
Western Cape
Other [outside SA]
If Other [outside SA] has been selected, please more details, e.g. Country.
Profession [HPCSA]
*
Dental Assisting, Dental Theraphy, and Oral Hygiene
Dietetics and Nutrition
Emergency Care
Environmental Health
Medical and Dental Professions
Medical Technology
Occupational Therapy, Medical Orthotics, Prosthetics and Arts Therapy
Optometry and Dispensing
Nurse
Physiotherapy, Podiatry and Biokinetics
Psychology
Radiography and Clinical Technology
Speech, Language and Hearing
Registrar
Students
Other
Membership [Indicate if you are currently a member]
*
PACASA
RuDASA (You get the Forum Daily Digest)
RuReSA (You get the Forum Daily Digest)
RuNurSA
SAAFP
Not a member of any of the above
Office Phone Number
Please enter a valid phone number.
Cellphone Number
*
We will use this number to communicate via WhatsApp or Telegram.
Who will settle the invoice
*
Myself / Individual
My affiliation / institution
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Registration details.
My Products
*
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Pre-Conference Workshops
3,750.00
ZAR
Registration Options
POCUS
PHD
Item subtotal:
0.00
ZAR
Early Bird Registration
Early Bird Registration rates must be paid before the end of June 2024.
3,800.00
ZAR
Registration Options
Doctors [GP/FP & Dentists]
All other professionals [including Registrars]
Allied Workers
Undergraduate Students & CHW
Day registration - All professionals
Day registration - Undergraduate & CHW
Speakers [Guest]
Normal Registrations Rate
Normal registration rates must be paid before the end of August 2024.
4,700.00
ZAR
Registration Options
Doctors [GP/FP & Dentists]
All other professionals [including Registrars]
Allied Workers
Undergraduate Students & CHW
Day registration - All professionals
Day registration - Undergraduates & CHW
Speakers
Sponsored delegates
Dietary Requirement [All options are Halaal and Kosher friendly, should you wish to order strictly Halaal and Kosher, then you need to select the strictly option below]
Price per person per day. If you attend 2 days you need to select 2 tickets.
Free
ZAR
Select Dietary Requirements
Quantity
Price
None
0
1
2
3
0.00
ZAR
Halaal [friendly]
0
1
2
3
0.00
ZAR
Kosher [friendly]
0
1
2
3
0.00
ZAR
Vegan
0
1
2
3
0.00
ZAR
Vegetarian
0
1
2
3
0.00
ZAR
Strickly Halaal
0
1
2
3
0.00
ZAR
Strickly Koshner
0
1
2
3
0.00
ZAR
Item subtotal:
0.00
ZAR
Carbon Footprint offset
An amount of R80.00 is included in the registration fee. If you do not wish to offset your Carbon Footprint for the conference please select this box.
80.00
ZAR
Quantity
1
Item subtotal:
0.00
ZAR
I will be attending the Gala Dinner and prize giving taking place at the Accolades Conference Centre, Friday, 14th of August 2026
*
Yes
No
If you selected a Day Registration rate, please indicate which day you will attend.
-
Month
-
Day
Year
Date
Friday, 5th September 2025
Yes
No
Saturday, 6th September 2025
Yes
No
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Affiliation or Institution details for invoice
Affiliation or Institution Name
*
Affiliation or Institution VAT number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Procurement Contact Name
First Name
Last Name
PersonalProcurement Email address
*
example@example.com
Procurement Contact details
Please enter a valid phone number.
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POPI Act: the RHC will not give out your contact details without your permission except when there is a specific request for information from: RuDASA, RuReSA, PACASA or RuNurSA. A delegate/presenter wants to contact another delegate /presenter. HPCSA requests attendance registers for the CPD activity. We do not give out attendance registers. For any other requests we contact you before sharing your contact details.
I have read and accept this
I will contact you privately - do not accept.
Thank you for your registration. We will send you an invoice within the next 24 business hours.
Please verify that you are human
*
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