ONLINE REGISTRATION

Only fully completed registrations will be accepted. Each participant will receive a registration confirmation.
If the maximum attendee capacity is reached, the Organisers reserve the right to refuse any registration.

General Information

First Name*

Last Name*

Title

Institution/Hospital

Place and Date of Birth (DD/MM/YYYY)*

Address*

City*

Postal/Zip Code*

Country*

Phone Number

Mobile Number*

Fax Number

Email*

Fiscal Code (Italians only)

Registration Fees

REGISTRATION FEES (VAT included)*

TEAR 2021 - In presence: € 366,00

TEAR 2021 - Online: € 183,00

TOTAL

Payment Method

Payment Method*

Bank Transfer

Pay Online with PayPal or Credit Card

FC EVENTI Srl
BANK: BANCO BPM SPA
ADDRESS: Via Guerrazzi 32 – 40125 Bologna, Italy
IBAN: IT94T0503402437000000000077
BBAN: T0503402437000000000077
BIC: BAPPIT21208
DESCRIPTION OF PAYMENT: “TEAR 2021 REGISTRATION DR. (LAST NAME)”

Bank charges are the responsibility of the payer and should be paid at source in addition to the registration fees. Please note that registration will not be effective until payment of the registration fee has been received by the Organizing Secretariat.

Please, upload copy of the bank receipt*

Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 50 MB.

When you click the submit button you will be directed to PayPal to complete your payment!

Details for Invoice

Name of Individual, Company or Organization*

Address*

City*

Postal/Zip Code*

Country*

VAT ID Number/National Insurance Number*

SDI Code (Italians Only)

Certified E.mail

Cancellation Policy

All cancellations must be notified in writing to the Organising Secretariat. Refunds will be processed after the Congress. Requests for refunds made after the Congress will not be considered.

Refund of registration fees:
• cancellations on or before November 12, 2021: 30% will be withheld
• cancellations after November 12, 2021: no refund

Privacy and Treatment of Personal Data

Consent*

I have read the Privacy Policy and consent to the use of my personal data for the purposes specified therein.

Terms of Participation

Terms of Participation*

The personal data you provide will be used to register you for this event. By completing this registration form, you accept the Terms & Conditions and the Data Collection Consent.

Yes, I understand that my information will be processed and shared with the aforementioned parties in order to process my registration.

No, I do not want my information processed and shared with the aforementioned parties and understand I will not be registered.

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