Surname First name Title Professor Doctor Ph.D. Ph.D.-student Medical Student Nurse Fystiotherapist Institution/ Company Department Address Postal Code City Country E-mail Country code + phone No. Country code + mobile No. Accompanying person Surname Accompanying person first name Registration fee - included 25 % VAT: Paid before March 1st, 2010
Paid after March 1st, 2010
Senior Participant DKK 2800 (EUR 375)
DKK 3300 (EUR445)
Young Participant* DKK 1500 (EUR 200)
DKK 2000 (EUR 270)
Accompanying person DKK 750 (EUR 100)
DKK 750 (EUR 100)
One day Fee 5 May (non-physicians, eg.nurse, physiotherapist, young doctors.) DKK 500 (EUR 68) One day Fee 6 May (non-physicians, eg.nurse, physiotherapist, young doctors.)
DKK 500 (EUR 68) One day Fee 7 May (non-physicians, eg.nurse, physiotherapist, young doctors.)
DKK 500 (EUR 68) One day Fee 5 May Senior doctors. DKK 900 (EUR 120) One day Fee 6 May Senior doctors. DKK 900 (EUR 120) One day Fee 7 May Senior doctors. DKK 900 (EUR 120)
* 35 years and younger. ID (passport) must be shown at the registration in Aarhus.
Date of birth: (dd-mm-yyyy) Workshops "Hands on workshops" for trainees and younger specialized orthopaedic surgeons. Theory and practice, surgery on saw bones. You will work in groups of 2-4. Max 20 doctors per session. Price per person per workshop DKK 250/ EUR 35 included 25 % VAT. Wednesday May 5th at 09.15-12.00 Proximal femoral fractures treated with intramedullary nailing Wednesday May 5th at 13.15-16.00 Flexible Intramedullary Nailing in Pediatric Shaft Fractures. Thursday May 6th at 09.15-12.00 Proximal femoral fractures treated with intramedullary nailing Thursday May 6th at 13.45-16.30 Flexible Intramedullary Nailing in Pediatric Shaft Fractures. Social Programme Tuesday May 4th at 19.00-20.30 Mayor's Welcome Reception and Buffet at the City Hall (Incl. in the registration fee) Wednesday 5th May at 12.30-13.30
Acta Lunch (Incl. in the registration fee)
Wednesday May 5th at 18.30-19.15 Acta Champagne Reception Thursday May 6th at 19.00-23.30 Gala Dinner Numbers of tickets DKK 500 (EUR70) per person Excursions for accompanying persons - CANCELLED Wednesday May 5th
Wellness - tour - Lübker Square - price per person DKK 900 (EUR 122)
Number of persons
Thursday May 6th
Aarhus Tour - price per person DKK 560 (EUR 76)
Number of persons
The above excursions are based on a minimum of 20 participants. LUNCH Friday May 7th As Friday is the last day we ask you kindly to indicate your wish for lunch this Friday: Total DKK Payment By cheque in DKK, made payable to : “NOF2010”, c/o KongresKompagniet, Nordhavnsgade 1, DK-8000 Århus C, Denmark drawn on: Danske Bank, 2 –12 Holmens Kanal, DK-1092 Copenhagen K., Denmark Transferred to ”NOF2010”, c/o KongresKompagniet, S.W.I.F.T. DABADKKK account No. 3643 3632584598, Danske Bank, Holmens Kanal 2-12, DK-1092 Copenhagen K, Denmark. PLEASE state name and “NOF2010”. IBAN: DK33 3000 3632 5845 98 By credit card (please have your credit card ready for online payment)
Accommodation To obtain the stated room prices reservation and booking MUST be done through KongresKompagniet by filling in and submitting this form. Please state alternative hotel I have arranged my own accommodation Hotel Royal - Junior Suite - DKK 2200/ EUR 296 Hotel Royal - single room - DKK 1500/ EUR 202 Hotel Royal - double room - DKK 1900/ EUR 256 Hotel Marselis - single room - DKK 1060/ EUR 143 Hotel Marselis - double room - DKK 1260/ EUR 170 Hotel Atlantic - single room - DKK 1000/ EUR 135 Hotel Atlantic - double room - DKK 1200/ EUR 162 Scandic Hotel Plaza - single room - DKK 1150/ EUR 155 Scandic Hotel Plaza - double room - DKK 1350/ EUR 182 Hotel Cab Inn - single room - captain - DKK 735/ EUR 99 Hotel Cab Inn - double room - captain - DKK 925/ EUR 125 I wish to share a double room with (please state name) Payment directly to the hotel upon departure. All room prices are inclusive breakfast, VAT. Date of arrival Date of departure Please state if you have any requests regarding meals, accommodation etc.