South African Registration Form

Welcome to the Global Self-Care Federation World Congress Cape Town 2022 Registration Form

Registration Type

Individual

Group 1 - 11

I am not attending

Group Contact

Contact Details

Title:

First Name:

Last Name:

Organisation:

Email Address:

Country Code:

Telephone Number:

Mobile Number:

Country:

Address:

VAT Number:

Group Members

Group Size

Contact Details

Title:

First Name:

Last Name:

Organisation:

Position:

Email Address:

Country Code:

Telephone Number:

Mobile Number:

Country:

Province / State:

Dietary Requirements:

If 'Other' please specify:

Disability Access:

Payment Details

Billing Title:

Billing First Name:

Billing Last Name:

Billing Organisation:

Billing Address:

City:

Province / State:

Country:

Postal / ZIP code:

VAT Number:

Privacy:

Opt In for sponsors and exhibitors to view my contact details

Opt Out for sponsors and exhibitors to view my contact details

Welcome Dinner

Date: Oct 19, 2022

Attending FULL

Not Attending

Additional Tickets FULL

1,250.00

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