Registration Form - ‘The Worn Dentition’

 

Fax Completed Registration to:  (07) 3720 1235      

 

By completing and returning this form you agree to abide by the terms and conditions. To view the terms and conditions, Click Here.

Text Box: Title: Text Box: First Name: Text Box: Surname: Text Box: Mobile Phone: Text Box: Work Phone: Text Box: Address: Text Box: State: Text Box: I would like to attend the following course: Text Box: Postcode: Text Box: Contact Details: Text Box: TheWornDentition Text Box: heWornDentition Text Box: (Registration includes morning refreshments, lunch and afternoon tea) Text Box: Payment Details: Text Box: Credit Card Number: Text Box: Expiry Date: Text Box: Name on Card: Text Box: Card Holder’s Signature: Text Box: CANCELLATION POLICY Any registered participant whose cancellation is received in writing at least twenty (20) business days prior to a seminar for which the participant is registered for, will receive a refund of 75% of the registration fee paid. Any registered participant who cancels his or her registration within twenty (20) business days prior to a seminar for which the participant is registered for, will not receive a refund of the registration fee. Sue Taji Dental reserves the right to cancel a seminar at any time. If so, any fees paid to the Organiser by any registered participants will be refunded in full. The Organiser will have no further responsibilities nor be liable for any loss of income or cancellation fees of travel arrangements or accommodation or other monies expended by the participants. Text Box: DentalUpdate2010

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