Registration profile

last call bid

Personal data

Gender

Male Female

First Name *

Last Name *

Title

Work place

Phone

E-mail *

Street Address

Postal code

City

Province

Country

Accommodation

I'd like to book a room

Mercure Gdansk Stare Miasto/ Mercure Gdansk Old Town

Accommodation type

Price per night

Choice of accommodation

Single room

Twin room

Triple room

Length of stay

Stay from

Stay to

Additional information

Activities

Gala Dinner

Description

Participation in Dinner. In the case of an accompanying person, mark a larger number of tickets

Price

Quantity

Payment summary

Chosen currency

Payment method

Click in the picture to choose payment method

Invoice data

Type of Payer

Company / Institution

Individual

Company name *

Address *

Post code *

City *

Country *

VAT ID No. *

Other e-mail to send invoices

Comments

* I hereby consent to the recording of my presentation during the Baltic Hernia Days Conference, which will take place on November 7–8, 2024, in Gdańsk. I also grant AsteriaMed Publishing Bielski Wardziński sp. j. the exclusive right to use and distribute my likeness captured in the materials, and I allow the use and distribution of the substantive content contained in these materials for non-commercial purposes.

I consent to the processing of my personal data for marketing purposes (both own services and those of third parties) by AsteriaMed Bielski Wardziński sp.j. I declare that I have been informed about the voluntary provision of personal data and the right of access to the content of my data and the right to correct it

I consent to receiving commercial information, including marketing information, electronically by AsteriaMed Bielski Wardziński sp.j.

I consent to the processing of my personal data for the purpose of organizing this and subsequent Baltic Hernia Days conferences by AsteriaMed Bielski Wardziński sp.j. I declare that I have been informed about the voluntary provision of personal data and the right of access to the content of my data and the right to correct it.

I have read the store's terms and conditions available on the website www.balticherniadays.eu/eng (direct link: https://1drv.ms/b/s!AiDgyWs10SPN2mYFdS20O3X1Cygt?e=tatRU7) and I accept them.

Registration Form