Euro-ataxia 2024 Conference Booking

Name(Required)

First Last

Email(Required)

Organisation you are representing and Country(Required)

Are you a wheelchair user?(Required)

Yes, I am a wheelchair user

No, I am not a wheelchair user

Do you have any dietary requirements or allergies?(Required)

If not applicable, please simply type N/A into the text box below.

Do you have any additional accessibility requirements?(Required)

If not applicable, please simply type N/A into the text box below.

Tickets include lunch and refreshments on Friday and Saturday.

Ticket(Required)

£100 – Euro-ataxia member organisation (max 3 per organisation)

£160 – Non Euro-ataxia members (patient organisations)

£300 – Industry

Total

Billing Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Credit Card

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