CLN Informatics Forum 04 June, ACC Liverpool Please complete one form per delegate and fax or email to: NHS Confederation Events Team, fax 0844 774 4211 or scan and email to eventbookings@nhsconfed.org Step 1 Complete your delegate information *Required fields Title Forename* Surname* Job title* Organisation name* Address* Postcode* Email address* Telephone no. Mobile no. For onsite communication only* Please use this space to tell us about any dietary or access requirements you may require Step 2 Select your method of payment Passes cost £49 per delegate Please invoice* my organisation for the sum of £ Please supply a PO number here. If you are waiting for this to be raised, please enter your email here. Invoicing Address: Please provide a valid invoicing address to complete your booking Postcode *Invoices must be paid in full before the event and within 30 days from date the invoice is raised. Step 3 Please sign below to confirm you have read and understood the terms and conditions of your booking. 1. The programme i. Programme details are correct at time of going to press. It may be necessary for reasons beyond the control of the organisers to alter the content and timing of the programme or the occasional identity of the speakers. We therefore reserve the right to make changes where necessary. 2. Delegate bookings and rates i. In order to book your place you will need to provide your registered finance address at the point of registration. ii. If a registered finance address is not made available to you at the point of booking please contact eventbookings@nhsconfed.org. Your enquiry will be processed within 24 hours. iii. Delegates will receive an automated confirmation of their booking. If you have not received that confirmation within five working days of your registration, please email the registration team on eventbookings@nhsconfed.org iv. Registration details and a map will be sent prior to the conference. v. We reserve the right to change the rate that delegates are booked onto to ensure they are using the appropriate rate. vi. Conference places are not transferable, however delegate substitutions are possible. Any changes must be received in writing four weeks prior to the event or after this time, upon arrival at the conference registration desk. vii. All cancellations must be made in writing. If you cancel your booking less than ten weeks prior to the event you will be charged 50 per cent of the delegate fee. If you cancel less than six weeks prior to the event you will be charged the full delegate fee. This charge covers the cost that we incur on your behalf. 2. Data protection i. We will include your personal details on the delegate list. The delegate list allows you to see who else is attending the event and can help with networking. ii. Your conference badge will have a bar code on it which can be scanned by exhibitors to capture your personal information such as your name, job title, organisation and email address. Please inform the exhibitor at the time if you do not wish to have your details scanned. iii. We find it helpful to have a note of your mobile phone number so that we can contact you during the event with news or changes to the programme. We will not share this information with any other party Signature: Date: