MPC Contact Form - Medicontur Events

DOCTOR REGISTRATION TO MPC

Registration fee is EUR 600/person

Cost includes:

2 days of intensive scientific program
Factory Visit in Zsámbék Headquarters
Refreshments and lunches on both program days
Dinner and Budapest sightseeing (8^thNovember, 2019)
2 nights of accommodation in Sofitel Budapest Chain Bridge
(7-9^thNovember, 2019)
VAT

Additional information:

Registration deadline is 7^th October, 2019
Registration fee is to be paid the latest by the 25^thOctober, 2019
Check in time to Sofitel Budapest: 14:00 on the day of arrival
check out time from Sofitel Budapest is 10:00 on the day of departure

REGISTRATION FORM

Distributor Company *

Invoicing Details (Billing Address) *

Doctor's Title *

Doctor's First name *

Doctor's Last name *

Doctor's Institution *

Country and city of Doctor’s workplace. *

Doctor's E-mail Address *

Doctor's Specific Dietary Requirement *

Would the participant like to extend his/her accommodation at Sofitel Budapest until the 10th of November (night of 9th November) at the rate of 180 EUR / room / night including taxes and breakfast for single-use?

This extra cost needs to be covered by the participant and paid at the Hotel directly.

Is the Doctor bringing an accompanying person?
(Extra cost for double room supplement: 28 EUR /room/night – paid by the individual not covered by Medicontur.)

First Name (accompanying person)

Last Name (accompanying person)

Special dietary requirement (accompanying person).

Will the accompanying person join the Church visit at Zsámbék? (required)
(No cost attached)

Will the accompanying person join the sightseeing & dinner on the 8th of November? (required)
(Cost: 90 EUR/Person)

Comments

By means of accepting the present declaration, I give my consent for Medicontur Orvostechnikai Kft. (hereinafter referred to as: Data Processor) to register my personal data that I have voluntarily handed over (name, e-mail address, phone number, etc.), to process them for the purpose of continuous cooperation until this declaration is revoked by me, but the latest for 3 years from the issuing of the present declaration, and to store them in order to be able to keep contact until the data processing activities end. Data Processor may use the personal data that I have handed over for the following purposes:

Providing me information about new products and related academic materials, getting in touch for marketing purposes.

Providing me information about Medicontur related events.

Sending me newsletters.

Based on the previous information provided by the Data Processor, I acknowledge that I may modify or withdraw the present consent by means of sending a postal letter to Medicontour Orvostechnikai Kft to the address Hungary, 2072 Zsámbék Herceghalmi út 1., or by means of sending an e-mail to the address unsubscribe@medicontur.com. I acknowledge that Data Processor shall only accept my electronic declaration of withdrawal if I send it from my e-mail address that had been previously provided for the Data Processor. Furthermore, through the communication channels that have been provided I have the possibility to request to look into my personal data that are stored by Medicontour Kft., and I may request the rectification and deletion of my personal data. I also accept that if my consent is withdrawn, the Data Processor shall take measures within 30 days to permanently, irrevocably delete my personal data form all records, and to subsequently terminate using them. I acknowledge that I have the possibility to acquire further detailed information about the use of my personal data and relating rights from the Data Protection Policy of the Data Processor that is published at the site http://www.medicontur.com/privacy_policy.