All information should be typed in upper and lower case (eg: Mary Smith).
On completion of the form, click on the "Submit Registration" button at the end of this form.
You have the option of paying either by cheque or credit card (using a secure site)
A Tax Invoice will be sent upon registration to the email address you provide, which may be printed.

Personal Information

Surname

First Name
Title (Mr/Mrs/Ms/Dr/Prof)

Organisation

Position

Postal Address
Locality

Town/City (or Country if living outside of New Zealand)

Daytime Telephone
 
Format: NZ = 01 234 5678, International = +_ _ 1 234 5678

Home Telephone
  as above

Mobile Phone
  as above

Email

Please ensure that your email address is correct as your invoice and all correspondence will be sent to this address.

Special Requirements
Dietary: please describe
Mobility: please describe
Other:  please describe
Preferred Name Badge
First Name:    Last Name: 

Privacy Act

The Privacy Act (NZ) 1993 states that, before your name and address details can be published in the list of delegates, either for distribution to fellow delegates or any other party, you must give your consent.

If you do NOT wish your name and organisation details to be available to sponsors and profiled in the conference handbook, please tick this box.

If you do NOT wish your email address to be available to sponsors and profiled in the conference handbook, please tick this box.


Conference Fees (All prices are GST inclusive)
Standard fee
(Upto 13 October)
Late fee
(After 13 October)

Full Registration

Includes

  • all morning and afternoon refreshments
  • lunches
  • 1 ticket for the cocktail function
  • 1 ticket to the conference dinner
  • both breakfast sessions
 Consultant member
$1,200.00
$1,300.00
Consultant non-member
$1,300.00
$1,400.00
RMO/Trainee member
$600.00
$700.00
RMO/Trainee non-member
$650.00
$750.00
Nurse/Allied health professional member
$450.00
$530.00
Nurse/Allied health professional non-member
$500.00
$580.00
Day Registration
(Includes morning and afternoon refreshments and lunch)		 Consultant
$400.00
$450.00
RMO/Trainee
$300.00
$330.00
Nurse/Allied health professional / Life members
$200.00
$250.00

Cocktail Function (Wednesday 24 November)

One cocktail function ticket is included with full registration.

Number of additional tickets required at $25.00 each
$0.00

Conference Dinner (Thursday 25 November)

One conference dinner ticket is included with full registration.

Number of additional tickets required at $110.00 each

$0.00

Satellite Meetings (Tuesday 23 November)
 
Standard fee
(Upto 13 October)
Late fee
(After 13 October)
NNFVIC – Child Protection Special Interest Group
$50.00
$75.00
Paediatric Palliative Care – an emerging speciality
$79.00
$90.00
Developmental / Community Paediatrics
            Medical Professionals
$150.00
$170.00
            Other Health Professionals / Students
$75.00
$95.00

Paediatric Transplant Satellite Meeting (Friday 26 - Saturday 27 November)
Standard fee
(Upto 13 October)
Late fee
(After 13 October)
$50.00
$75.00

Paediatrics Self-Hypnosis Workshops (Friday 26 - Sunday 28 November)
 
Physicians / Dentists
(Upto 13 October)
Allied Health
Professionals / Nurses
(Upto 13 October)
Late Fee
(After 13 October)
Beginners Course
$950.00
$800.00
$1050.00
Intermediate Course
$950.00
$800.00
$1050.00

Payment Method
Total Cost
$0.00
Credit Card online
 Pay by Cheque
Cancellation must be notified in writing (post/email) to the Organiser.
Cancellations received before Monday 1 November 2010 will be refunded less a $50.00 cancellation fee.
No refunds will be issued on or after this date.