BOOKING FORM
RCPCH COURSES AND EVENTS
Please return your completed booking form to:
Email events@rcpch.ac.uk
Post Events, Royal College of Paediatrics and Child Health, 5-11 Theobald's Road, London WC1X 8SH
EVENT | Please add information about the course or event – see listing on www.rcpch.ac.uk/events
Event name
Date(s)
Location
Fee (please note fees vary depending on your membership
status and role)
☐RCPCH Member – Trainee or SAS doctor
☐RCPCH Member – Consultant
☐Non-member
☐Other (please describe below)
DELEGATE | Please add your contact information
Title
First name
Surname
Job title
Hospital / Trust /
Organisation
Contact address
Contact phone
Email address
Are you an RCPCH member?
☐Yes
☐No
If yes, please add your membership number
Please note any dietary or access requirements
How did you hear about this course or event?
☐RCPCH eBulletin
☐RCPCH Events and Courses eNews
☐Social media (eg Twitter, Facebook)
☐Flyer
☐Word of mouth
☐Other (please describe below)
☐ I confirm that the above information is correct to the best of my knowledge
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PAYMENT
We can accept payment by cheque, debit card or credit card. Please check www.rcpch.ac.uk/events for the
fee for this event
☐
Cheque | Please make payable to the 'Royal College of Paediatrics and Child Health'
☐
Card payment | We accept the following only:
-Debit card
☐Visa
☐Visa Electron
-Credit card
☐Visa
☐MasterCard
☐Solo
(please note a 4% surcharge applies to credit cards)
Name on card
Card number
Expiry date (mm/yy)
Security Code (3 digits)
I authorise you to debit my account with the amount of:
£
Please enter fee
(+ 4% surcharge for credit cards)
Cardholder signature
For electronic forms, type name
Today’s date (dd/mm/yy)
______________________________________________________________________________________
CANCELLATION POLICY
Cancellations by delegates
To cancel a place on RCPCH events and courses, notice of cancellation must be given by email to
events@rcpch.ac.uk.

If you cancel at least 28 working days prior to the start of the course you will receive a full refund
minus a 10% administration fee.

If you cancel between 28 and 10 working days prior to the start of the course you will receive a 50%
refund.

If you cancel less than 10 working days before the event you will not be entitled to a refund.
No refund will be made for non-attendance on the course.*
The College will accept name changes for attendees. Please inform the Events Team 10 working days prior
to the event on 0207 092 6106 or email events@rcpch.ac.uk.
Cancellations by RCPCH and changes to course content
RCPCH events and courses are constantly updated and while we endeavour to deliver the courses as
advertised there may inevitably be occasions where we have to change content without prior notice or, in
exceptional circumstances, to cancel an event.
In the case of a course cancellation delegates will either be offered an alternative date, a credit note or a full
refund and we will also consider any reasonable request to cover non-refundable travel arrangements if a
course is cancelled within 10 working days of the start day. RCPCH will not compensate for time spent
travelling or away from the place of work.*
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*Occasionally circumstances will arise which result in the need to cancel, reschedule or postpone an event, due to an unforeseen
occurrence or act of God. When this is the case RCPCH shall assume no liability.
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