Registration online


1. MY CHOICES
Fees
3-DAY-COURSE
Access to the Course and the Exhibition,
Delegate Bag,
Congress Book,
Welcome Reception Invitation,
Live Surgery Session,
Knot Tying Workshop,
Shoulder Model Workshops,
Coffee Breaks and Lunches		 1200 €
Cadaver workshop
 500 €
Live surgery - Hotel Palais de la Méditerranée
 0 €
Plastic Model Workshop
 0 €
2. MY CONTACT INFORMATION
 Firstname
 Lastname
 Address
 Zip Code
 City
 Country
 Phone
 Email
 Date of birth
(Day/month/year)
(ex: 25/01/2011)
 Years of specialization in
Orthopaedic Surgery
 Practice of a
shoulder fellowship :
 Please list your level
of experience regarding
shoulder arthroscopy below:		 I perform less than 25 shoulder arthroscopies annually
I perform 25-75 shoulder arthroscopies annually
I perform 75-150 shoulder arthroscopies annually
I perform over 150 shoulder arthroscopies annually
 Please list your level
of experience regarding
total shoulder replacement surgery below:		 I perform less than 3 shoulder replacement surgeries annually
I perform 3-10 shoulder replacement surgeries annually
I perform 10-25 shoulder replacement surgeries annually
I perform over 25 shoulder replacement surgeries annually


Registration by post

Please print the following registration form : REGISTRATION FORM and send it with your payment only in euro made out to A.E.R.C.O.T. to :

SARL Impact
10, Rue Ribotti - 06300 Nice - France
Phone/Fax : +33(0)4 92 07 35 76

Terms and condition

3 - Day course : 1200.00 € per person
The registration fee includes:
Access to the Course and the Exhibition
Delegate Bag
Congress Book
Welcome Reception Invitation
Live Surgery Session
Knot Tying Workshop
Shoulder Model Workshops
Coffee Breaks and Lunches

Cadaver Workshops 500.00 € per person and per workshop


Payment

By bank transfer to the following account:
Account holder: A.E.R.C.O.T.
Credit Lyonnais - Nice Victor Hugo
IBAN: FR34 3000 2032 6100 0079 0416 T45
SWIFT (BIC): CRLYFRPP

Very important:
When making a bank transfer, it is mandatory to mark your name, and to send the copy of the transfer receipt with the registration form to:

SARL Impact
10, Rue Ribotti - 06300 Nice - France
Phone/Fax : +33(0)4 92 07 35 76
France Bank fees are at the charge of the registrant.

By check
Print this form and send it with your payment only in euro made out to A.E.R.C.O.T. to :

SARL Impact
10, Rue Ribotti - 06300 Nice - France
Phone/Fax : +33(0)4 92 07 35 76

Attention : Due to the limited numbers of places, registration for cadaver workshops is only possible through the website.


Cancellations

For cancellations before April 10, the sum of 50€ will be retained for administrative costs.
After April 10, no refunds will be possible.

For more information or accommodation during the Nice Shoulder Course, please contact:
IMPACT Ltd./Christina Loicht
10, Rue Ribotti - 06300 Nice - France
Phone/Fax : +33(0)4 92 07 35 76
Email. christina@impact-events.net


Official Carriers


Get the best price for your flight with Air France and KLM Global Meetings.
Event ID Code to keep for the booking: 12999AF
More détails : http://www.airfranceklm-globalmeetings.com/

For more information or accommodation during the Nice Shoulder Course, please contact:
IMPACT Ltd./Christina Loicht
10, Rue Ribotti - 06300 Nice - France
Phone/Fax : +33(0)4 92 07 35 76
Email. christina@impact-events.net

 

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