REGISTRATION FORM SDCA Certification Course in London Saturday, March 14th, 2015 Double Tree by Hilton Hotel – Tower of London “The Extracorporeal Shock Wave Therapy in theory and practice” Please complete the application form below and return it to Marie-Christine Collet at [email protected] or by fax at: +41 22 99 4738 Faculty: Dr. Manoj Sood, Consultant Orthopaedic Surgeon, Hip, Knee & Sports Specialist, London Paul Morrissey, Principle Osteopathic Clinic Physical Medicine Clinics Surrey Registration fee: £ 75.00 including VAT made payable to EMS Electro Medical Systems SA. This fee is non refundable and includes course materials, lunch and refreshments. Special 20% discounted registration fee of £ 60.00 for participants who are already SDCA certified practitioners Location: Double Tree by Hilton Hotel – Tower of London 7 Pepys Street, London, EC3N 4AF – UK Please contact the hotel directly to make your own hotel reservation at +44 207 709 1000 or make your booking online. I hereby register for the SDCA certification course "The Extracorporeal Shock Wave Therapy in theory and th practice" on Saturday, March 14 , 2015 in London. Miss. Mrs. Mr. Title: First Name: Family Name: Address Hospital/Surgery: Name of Institution: Occupation: Address: Postcode: Country: Phone: Fax: E-mail: Date / Signature: Conditions of participation: together with the confirmation of your registration you'll receive an invoice about the registration fee. This invoice must be paid in full two weeks before the course. No refunds will be offered. Unfortunately, very unlikely situations cannot be excluded that could make it necessary to cancel an SDCA course, or postpone it to another date. In any case, the SDCA cannot be held liable for (i) date, (ii) location, (iii) chairman, (iv) faculty, (v) content, (vi) performance and (vii) execution of an SDCA course. In case of lack of attendance or (personal) incapability of the chairman or a faculty member, SDCA reserves the right to cancel or postpone an SDCA course, or move an SDCA course to another location. In case of cancelling an SDCA course due to reasons SDCA is responsible for, prepaid registration fees will be refunded but any other claims against SDCA, the chairman and the faculty members of the SDCA course are excluded. In particular, SDCA, the chairman and the faculty members of the SDCA course are not liable and responsible for any costs and expenses that may occur when canceling or postponing an SDCA course, or moving an SDCA course to another location. SDCA is only liable and responsible for damage caused deliberately or through gross negligence. Anyway, SDCA is not liable and responsible for any items lost during the SDCA course. Regulations valid as of January 2015. Note: we will be taking photographs during the course for promotional and educational purposes. The photographs may be used for promotional purposes and online materials (advertising, enewsletters, websites). They may be kept for an unlimited period and may not be used immediately. SDCA – Swiss DolorClast® Academy C/O E.M.S. ELECTRO MEDICAL SYSTEMS SA – Chemin de la Vuarpillière 31 – CH-1260 NYON – Tél: +41 (0)22 994 47 00 [email protected] / www.swissdolorclastacademy.com Swiss DolorClast® Academy Certification Course The Extracorporeal Shock Wave Therapy in Theory and Practice LOCATION: DOUBLE TREE BY HILTON HOTEL – TOWER OF LONDON 7 Pepys Street, London, EC3N 4AF – UK The DoubleTree by Hilton London – Tower of London is situated adjacent to Fenchurch Street station in the heart of the historic City of London. The Financial District and London’s main tourist attractions; Tower of London, Tower Bridge and The London Dungeon are a short walk from the hotel. Oxford Street and the West End are equally accessible. How to get to the hotel The hotel is in close proximity to Tower Hill underground station, Tower Gateway and Fenchurch Street train station (all within a 3 minute walk). From City Airport to hotel: Distance from Hotel: 7 miles Drive Time: 30 minutes Taxi - approx fare = £ 30.00 From Heathrow Airport to hotel: Distance from Hotel: 21 miles Drive Time: 75 minutes Taxi - approx fare = £ 90.00 Metro/Underground – Best and quickest way : Heathrow Express Train - approx journey 20 minutes to London Paddington Station. From Paddington Station to hotel - Circle line to Tower Hill Station or taxi ride – approx fare = £ 25.00. Piccadilly line from Heathrow Airport, change at Hammersmith to District line, leave tube at Tower Hill Station - the nearest station to the hotel. Journey Time - 90 minutes. From Gatwick Airport to hotel: Distance from Hotel: 31 miles Drive Time: 90 minutes Taxi - approx fare = £ 120.00 Metro/Underground – Gatwick Express Train – approx journey 30 minutes to London Victoria Station, non-stop, every 15 minutes. From Victoria Station to hotel – Circle line to Tower Hill Station or taxi ride – approx. fare = £ 18.00 SDCA – Swiss DolorClast® Academy C/O E.M.S. ELECTRO MEDICAL SYSTEMS SA – Chemin de la Vuarpillière 31 – CH-1260 NYON – Tél: +41 (0)22 994 47 00 [email protected] / www.swissdolorclastacademy.com Swiss DolorClast® Academy Certification Course The Extracorporeal Shock Wave Therapy in Theory and Practice LOCATION: DOUBLE TREE BY HILTON HOTEL – TOWER OF LONDON 7 Pepys Street, London, EC3N 4AF – UK DATE: TIME: LANGUAGE: March 14th, 2015 9:00 am – 5:00 pm English PARTICIPANTS: up to 40 participants FACULTY: Dr. Manoj Sood, Consultant Orthopaedic Surgeon, Hip, Knee & Sports Specialist, London Paul Morrissey, Principle Osteopathic Clinic Physical Medicine Clinics Surrey REGISTRATION: Registration form to return by e-mail at : [email protected] to Marie-Christine Collet before March 9th, 2015 Please contact Marie-Christine Collet at +41 (0)22 99 42 601 or Chris Downton at +44 (0)7469 241 209 for any questions. REGISTRATION FEE: Standard registration fee : £ 75.00 20% discounted registration fee : £ 60.00 for SDCA certified practitioners Payment of registration fee by wire transfer : Bank account number (GBP): 0251-502625-32-9 ....................................... Beneficiary: E.M.S. Electro Medical Systems S.A - 1260 Nyon - Switzerland Clearing number: 4835 ............................................................................... IBAN Code: CH88 0483 5050 2625 3200 9 ................................................ SWIFT Code: CRESCHZZ80A ................................................................... Payment instructions: Please specify your full name and "SDCA London 2015" ACCREDITATION: Upon completion of the course, participants will receive the Swiss DolorClast® Academy certificate and will be added on the SDCA website www.swissdolorclastacademy.com. SDCA – Swiss DolorClast® Academy C/O E.M.S. ELECTRO MEDICAL SYSTEMS SA – Chemin de la Vuarpillière 31 – CH-1260 NYON – Tél: +41 (0)22 994 47 00 [email protected] / www.swissdolorclastacademy.com
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