CONFERENCE REGISTRATION FORM World Conference on Drowning Prevention 2015

Please complete and return by e-mail to secretariat@wcdp2015.org with bank transfer receipt.

(The last name and title given here will be printed on your badge)

Participant’s Information

First Name: Last Name:

Title: Prof. Dr. Mr. Ms. Mrs. Other, please specify:

Nationality:

Organisation:

Position: ILS Member: Yes No

Address:

City: Postcode: Country:

Telephone: (M) E-mail:

Conference Fee:

REGISTRATION FEE EARLY BIRD

(Until 31 July 2015)

STANDARD

(From 1 August 2015 onwards)

Amount

Three Days Registration

Full USD 300 USD 370

Speakers USD 210 USD 300

Student USD 220 USD 340

Malaysian MYR 800 MYR 1000

One Day Registration

USD 170 - 4 Nov

USD 170 - 5 Nov

USD 170 - 6 Nov

ILS Conference Dinner USD 50

Grand Total:

Please review your registration details above and ensure the total for your registration fee is correct. If

any details are incorrect please edit accordingly.

Please review the Conference Registration’s Cancellation and Refund Policy and acknowledge these conditions prior to your submission. Upon receipt the complete registration form, an invoice will be issued for your payment purpose. By sending in this registration form, I acknowledge that I commit myself to the immediate payment of the full conference fee. I have taken notice of the cancellation terms on this form.

Date: Signature:

Conference Registration - Cancellation and Refund Policy

Cancellations must be received in writing - mail, email or fax - to Conference Secretariat, World Conference on Drowning Prevention 2015. Cancellations will not be deemed to be received until you have written confirmation from the Conference Secretariat. If you have not received acknowledgement within three business days, please contact the Conference Secretariat. There will be no penalty for cancellations received on or before 6 August 2015 (90 days prior to the conference). The full registration fee paid minus a USD $25 processing fee will be refunded. A cancellation fee of 50% of registration fees plus a USD $25 processing fee will be applied for cancellations received between 5 August 2015 and 16 September 2015 (89 and 45 days prior to the conference). No refund will be issued for cancellations received from 17 September 2015 (less than 44 days before the Conference). If a delegate fails to attend (Non-attendance), registration fees will not be refunded. Substitutions may be accepted however need to be advised in writing - mail, email or fax - to Conference Secretariat, World Conference on Drowning Prevention 2015. Insurance

It is strongly recommended that participants take out their own general travel insurance. It is suggested that the insurance policy should also cover loss of fees/deposit, airfares, accommodation charges, medical expenses, loss or damage to personal property and repatriation expenses. The Insurance should cover loss arising from the cancellation of the conference by the organisers or a person’s inability to attend due to any reason whatsoever. No responsibility is taken by the conference secretariat for any person not holding insurance.