BSRS 20th Annual Scientific Congress

Saturday 29th June 2013 & Sunday 30th June 2013

The Belfry

West Midlands

CONFERENCE REGISTRATION FORM

Name:……………………………………………………………………………………………

Address: ….………………………………………………………………………………………

………………………………………………………………………………………….

Present Post……………………………………………………………………………………

Tel No:…………………………………………E-Mail:………………………………………….

Full Delegate package to include accommodation on Sat 29th June at The Belfry
Before
31st May 2013
/
After
31st May 2013
/
Day Rate
/
Conference Dinner
/
2013Membership
Surgeon – Member
/
£320
/
£370
/
£140
/
FREE*
/
£90
(to include ISRS Membership)

Other – Member

/

£270

/

£320

/

£110

/

FREE*

/

£50

Trainee – Member

/

£220

/

£220

/

£ 90

/

FREE*

/

£30

Non – Member

/

£370

/

£420

/

£170

/

£50

**Trainee - Non Member

/

£270

/

£270

/

£120

/

£25

If you are booking for one day only, please specify which day you will be attending:Saturday 29th – Sunday 30th

*CONFERENCE DINNER ON SATURDAY 29th June 2013 IS INCLUDED FREE FOR BSRS MEMBERS BOOKING A FULL DELEGATE PACKAGE

**Confirmation of trainee status is required

Name of additional dinner guest for conference dinner on 29th June 2013(if applicable)

……………………………………………………………………………………………..Please remember to include additional payment (£25 per guest)

Dietary preference, if any ………………………………………………………………………….

PAYMENT DETAILS:-

I enclose a cheque to the value of £……………made payable to BSRS
I would like to pay by Debit/Credit Card Please call Jan Allsopp on029 20224443 / 07711746741
Payment can be made online via our website please visit

Please note that discounted prices only apply before Friday 31STMay 2013

RETURN THIS FORM TO:

BSRS, PO Box 5184, Cardiff. CF5 9DN

Tel: 02920 224 443

Email:

Website: 20th Annual Scientific Congress

Saturday 29th June 2013 & Sunday 30th June 2013

The Belfry

West Midlands

ACCOMODATION & VENUE INFORMATION:

Set in 550 acres of finest countryside in the West Midlands, The Belfry hotel is the ideal place to escape for business or pleasure; a place where you can be assured of a warm welcome.

This unique four star hotel is home to three world renowned golf courses, flexible conference spaces, and extensive leisure and spa facilities. A team of friendly, dedicated staff will ensure your visit to The Belfry is every bit as good as it should be. Let the staff at The Belfry tailor-make your perfect stay at this golf and spa hotel.

Directions
Road / Off the A446 to Lichfield [M42 Junction 9; M6 Junction 4 or M6 Toll Road Junction 2]
Further detailed directions can be found at
Rail / Birmingham International Station – 15 Minutes
Air / Birmingham International Airport – 15 Minutes

Single overnight accommodation on Saturday 29th June 2013 is included in the full delegate package.

Please contact the reservations office at The Belfry on 01675 470301 if you wish to book additional accommodation / upgrade / have specific requirements. Please quote BSRS when making reservation. If you book additional accommodation please notify Jan Allsopp on .

Full delegate packages are limited and will be allocated on the basis of first come first serve. Cancellations will only be subject to a refund if the full package can be re-allocated. Parking at the Belfry is free!