Chromosome 18 Registry and Research Society Europe. Conference 2012 Registration
Chromosome 18 Registry and Research Society (Europe)
Charity Number SC040399
2nd Family Conference Weekend
Marriott Milan
August 3-5, 2012


Important: you must book your hotel accommodation separately! See information below
Please give the names of all people coming to the conference and the ages of the children. We also need to know what syndrome affects your family member, especially affected children, so that we can organize the free childcare and siblings workshops.
A separate form will come out to families with children for childcare registration.


Delegates

Person1
First Name *
Last Name *
Age (if under 18) *
Relationship To The Affected Person *
Syndrome Group
Special Dietary Requirements (if any)

Person2
First Name (Optional)
Last Name (optional)
Age (if under 18) *
Relationship To The Affected Person *
Syndrome Group
Special Dietary Requirements (if any)

Person3
Last Name (optional)
First Name (Optional)
Age (if under 18) *
Relationship To The Affected Person *
Syndrome Group
Special Dietary Requirements (if any)
Address Of Main Contact
Building Name / Number *
Street *
Village / City / Town *
Post Code *
Country *
Preferred Phone Number *
Alternative Phone Number
Email Address *
Do you require translation services ?
If YES, to which language ?

Any other information you might like to add:

Payment
If you intend to come it would help us if you could pay the conference fee in advance using Bank Transfer. Please contact the treasurer if you have a problem paying by bank transfer, and we can make alternate arrangements.

Early Registration Discount
The Conference fee per unaffected adult is 30.00 Euro if you register by the 10Th of July, and will became Euro 45.00 for registration made after the 10th of July. There is no conference fee for affected adults or children under 18
Number of unaffected adults attending *
Conference Fee Total in Euros *

It would be best to book your accommodation soon. The Milan Marriott Hotel is holding a block of rooms for us until the 15th of July (or upon sold out) at the following price inclusive of Taxes and Breakfast:

.- Single room Euro 90,00
.- Double room Euro 90,00
.- Triple room Euro 105,00
.- Quadruple room Euro 115,00
but they will let them go to anyone after that date.
The phone number for Milan Marriott Hotel is +39 -02–48521. Tell them that you are booking for the Chromosome 18 Europe/ Agemo 18 conference. http://cwp.marriott.com/milit/agemo2012/


Chromosome 18 Registry and Research Society (Europe)
Registered Scottish Charity: SC040399

Agemo 18 Onlus (Italy)
Registered Italian Charity Fiscal Number: 98089350171

To make Payments from All Banks
Please pay the conference fee of €30.00 (by the 10ThJuly) or €45.00 (after the 10th July) per unaffected adult by an international bank transfer to Agemo 18 Onlus bank account using the IBAN number, and the SWIFT code below:
Money Transfer to:
Agemo18 Onlus
Banco di Brescia Ag. di Nuvolento
ABI 03500 - CAB 54810
IBAN: IT 33 B 03500 54810 000000009730
SWIFT CODE: BLOPIT22
Reference field : Conference fee

Please make sure that in the Reference field of the money transfer you specified you are paying the Conference fee and specified the name of the persons you are paying for.
When you have paid the conference fee, please send an e-mail to info@agemo18.org saying that you have paid. (for your security do not give any further details).
What is included in the price of registration?

Our family conference is an extremely important educational and networking tool of our organization. Each family is responsible for their hotel room or lodging; it is not a part of registration. The registration fee includes the group meals offered at the opening reception, other provided meals, the facility for our sessions, translation services in several European languages, childcare and related supplies, printed materials, and speaker costs. (Breakfast is included in your room fee if you have booked your accommodation with the Marriott Milan) We have charged each attendee a very nominal registration fee for the conference. It is our desire to make it possible for every family wishing to attend the conference to do so. Because of huge fundraising efforts by our members, we are able to offer a stipend (early booking discount) to attendees who are members. This means that, whatever the total cost is, the attendees cover a portion of it, and Chromosome 18 R&RS Europe/Agemo 18 covers a portion. Not everyone chooses to use the stipend because they know it is a Registry subsidy.

Please note that the stipend is a benefit that is only available to those whose Registry membership is active.

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