Update in Emergency Imaging 2024 Online regsitration form



Thank you for using our website for your registration for the Update in Emergency Imaging 2024 Meeting, November 21^st - 22^th, 2024 in Bruges - Belgium.
The procedure is quite easy and consists of 4 steps:
1. Submit your personal data
2. Make your registration
3. Make a payment through your creditcard or by banktransfer
4. Confirmation of registration request
IMPORTANT :
Please understand that for your registration to become firm, we have to receive the complete payment. If needed, you will receive an official certificate of payment.



To avoid technical difficulties PLEASE DO NOT Click on the "BACK button" while using the on-line registration system. Changes can be made at the end of the process ! Thank you.

1. Personal Data:
Title:
Family name	(*)
First name	(*)
Institution/University
Department
Street address:
Zipcode:	City:
Country:
Telephone:
Fax number:
Email address:	(*)
Invoice address: (1)
VAT number:

Special Dietary requests:

(1) if different than street address !

IMPORTANT :

We want to inform you that the information you are submitting will be treated under the legislation concerning private information and the General Data Protection Regulation of the EU.
Keep me informed regarding all future events of the Update in Medical Imaging Group.

2. Registration Participants:



Choose a category
(more information)
Delegate Radiologist, (900 Euro/ 950 Euro)
Delegate Resident (600 Euro/ 650 Euro).
Radiologist BSR member (850 Euro/ 900 Euro).
Resident BSR-YRS member (500 Euro/ 550 Euro).
Delegate Radiologist ESER member (850 Euro/ 900 Euro).
Delegate Resident ESER member (500 Euro/ 550 Euro).

RIZIV / INAMI number and Membership code(s):
Please submit your RIZIV / INAMI number if your are a Belgian physician and if applicable BSR/ YRS / ESER membership number.
RIZIV / INAMI number:
BSR membership number:
YRS membership number:
ESER membership number:

3. Social Activity (Optional)



Walking dinner 21 November 2024 - Rooftop of Concertgebouw Brugge
(more information)

Meet and Greet Congress Walking Dinner:
You are invited to join us on the Rooftop of the Concertgebouw Bruges on 21/11/2024 for a Meet and Greet Congress Walking Dinner. (NOT included in Registration Fees).
I will participate as a Delegate Radiologist, with person(s), costs: 100 Euro/pers.
I will participate as a Delegate Resident, with person(s), costs: 85 Euro/pers.

( Important: Please fill in the number of people, including yourself)