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Conference Registration Early Bird

Conference Registration Form with early bird discount

"*" indicates required fields

Step 1 of 6 - Personal Details

Hidden

Order Number

Registration Fee

Price:

Registration Fee

Salutation*

Name*

First Last

Email*

Mobile Phone*

Skype ID

Website

Current Member?*

Yes

Company Name*

Title/Position*

Countries Represented

Company Address ( for billing purposes )*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Dietary Restrictions

Photo Upload

Accepted file types: jpg, Max. file size: 1 MB.

Upload your picture (to be used in the conference booklet)
Max file size 1MB - JPG files only

Additional Team Member Attendance

Will you be bringing additional Team Members*

Yes

How many additional Team Members will be attending

Team Member 1

Salutation*

Name*

First Last

Email*

Mobile Phone*

Skype ID

Job Title / Position*

Location*

Special Dietary Restrictions Additional Team Member 1

Upload your picture (Team Member 1)

Accepted file types: jpg, Max. file size: 1 MB.

Upload your picture (to be used in the conference booklet)

Team Member 2

Salutation*

Name

First Last

Email*

Mobile Phone*

Skype ID

Job Title / Position*

Location*

Special Dietary Restrictions Additional Team Member 2

Upload your picture (Team Member 2)

Accepted file types: jpg, Max. file size: 1 MB.

Upload your picture (to be used in the conference booklet)

Team Member 3

Salutation*

Name

First Last

Email*

Mobile Phone*

Skype ID

Job Title / Position*

Location*

Special Dietary Restrictions Additional Team Member 3

Upload your picture (Team Member 3)

Accepted file types: jpg, Max. file size: 1 MB.

Upload your picture (to be used in the conference booklet)

Your Access to the P2P Scheduler

Please complete below to set up your P2P profile accordingly

Team Members*

Name of the Team Member in charge of setting up your Meetings

Additional Comments

About access to the P2P Scheduler, for multiple Team Members

All registered Attendees in your Group may have a login access to the P2P Platform.
If you designate only one person to coordinate meetings, only that person will receive login access.
The scheduler allows Attendees to invite colleagues to the meetings each one has set up. Attendees can block the times when they want to join colleagues.

Optional Post-Meeting Activities

Walking Tour - Sunday Afternoon
Fee will be determined by number of participants (USD $ 45/person or less)

Interested?*

Yes

Are you interested in Group Activities on Friday March 8th? You will receive More information .

Number of People Attending (Including Yourself)*

Additional Requests or Comments

First Participant

Name*

First Last

Second Participant

Name*

First Last

Third Participant

Name*

First Last

Terms and Conditions

Terms & Conditions - PBLA Annual Conference

1) I agree to pay the Registration Fee, upon presentation of invoice and prior to the Event.

2) Neither the Organising Committee of the event and its constituent members acting as organisers (known collectively as 'the Organisers'), nor Convention Management, can accept any liability for death, injury, any loss, cost or expense suffered by any person (including accompanying persons or partners or attendant caregivers), if such loss is caused or results from the act, default or omission of any person. In particular, neither the Organisers nor Convention Management can accept any liability for losses arising from the provision or non-provision of services provided by hotel companies or transport operators. Nor can the Organisers or Convention Management accept liability for losses suffered by reason of war including threat of war, riots and civil strife, terrorist activity, natural disasters, weather, fire, flood, drought, technical, mechanical or electrical breakdown within any premises visited by delegates and/or partners in connection with the meeting, nor losses suffered by reason of industrial disputes, governmental action, registrations or technical problems which may affect the services provided.

3) Cancellation policy:
a. Cancellation Requests must be submitted in writing
b. Cancellation Requests received after 60 days prior to the Event date will be refunded the full amount, minus administration fees and bank service charges.
c. For Cancellation Requests received up to 30 days prior to the Event date, will be refunded 50% of the paid amount minus administration fees and bank service charges.
d. For Cancellation Requests received less than 30 days, no refund can be granted.

4) Payment Method Charges
Credit Card: A 3.5% non-refundable Service charge will apply. A Secure Payment link will be provided with your registration details.
Bank Transfer: A non-refundable bank fee of $35 USD will apply. Bank information will be provided with the invoice.
Currency: all amounts are in US Dollars

Terms & Conditions*

YES - I have read, understood & agree to the Terms & Conditions

Conference Registration Early Bird

Additional Team Member Attendance

Team Member 1

Team Member 2

Team Member 3

Your Access to the P2P Scheduler

Guest Attendance

Guest 1

Guest 2

Optional Post-Meeting Activities

First Participant

Second Participant

Third Participant

Terms and Conditions

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