Registration form

15th Congress of the European Skull Base Society

5 - 8 June 2024

Deadline registration fees:

early fee: until 1 April 2024
pre-registration fee: 1 April - 1 June 2024
onsite fee: from 1 June 2024

Please complete the registration form below

Mr./Ms. *

Mr.

Ms.

Title

First name *

Last name *

Email address *

Specialty *

Other

Institute *

City *

Country *

BIG number (if applicable)

Are you an ESBS member? *

Yes, I am a member

No, I am not a member

I would like to register as industry staff

If you would like to become a member, please visit the ESBS website for your memberschip application. Please note: do not complete this registration before receiving your membership confirmation.

I would like to register for a: *

Full congress badge - ESBS member - pre-registration fee

Full congress badge - Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Day badge

LOES day badge (Dutch Skull Base Society only)

I would like to register as: *

Full congress badge - Non-members - pre-registration fee

Full congress badge - Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Day badge

LOES day badge (Dutch Skull Base Society only)

I would like to register as: *

Industry staff

Day badge member: *

Day 1: 5 June 2024

Day 2: 6 June 2024

Day 3: 7 June 2024

Day 4: 8 June 2024

Price day 1 badge: *

ESBS member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 2 badge: *

ESBS member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 3 badge: *

ESBS member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 4 badge: *

ESBS member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Day badge non-member: *

Day 1: 5 June 2024

Day 2: 6 June 2024

Day 3: 7 June 2024

Day 4: 8 June 2024

Price day 1 badge non-member: *

Non-member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 2 badge non-member: *

Non-member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 3 badge non-member: *

Non-member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Price day 4 badge non-member: *

Non-member - pre-registration fee

Resident, fellow, allied healthcare professional - pre-registration fee

Invited faculty

Congress diner: *

1 ticket - early fee

2 tickets - early fee

I will not attend the congress diner

If you have specific dietary requirements or allergies, please describe below:

Cancellation policy

Cancellation of registration has to be made in writing to the conference secretary (events.rha@radboudumc.nl)

Refunds will be provided as follows:
1.    for cancellations received 3 months or more prior to event - 95% refund
2.    for cancellations received 2 months prior to event - 80% refund
3.    for cancellations received 1 month prior to event - 50% refund
4.    for cancellations received 14 days prior to the event - 25% refund
5.    for cancellations received less than 14 days prior to the event - no refund

I accept the cancellation policy as described above *

Congress diner: 1 ticket - early fee

€ 130.00

Total: € 130.00

Registration form

Registration fee options

15th Congress of the European Skull Base Society, 5 - 8 June 2024