The South African Spine Society

20th Spine Congress: 20 - 22 May 2021

Century City Conference Centre, South Africa

Delegates

Payment :
Self Sponsored

Payment : Self

Payment : Sponsored

Billing Info

Delegate Info

Payment Option

Confirm

Billing Info

Company Name

VAT Number or n/a

Telephone

Full Address

Address 1

Address 2

City

Postal Code

Contact Person

Name

Surname

Mobile

Go to Delegate

Delegate Info

Delegate No. 1

Are you a SASS member?
Yes No

Fees over due R Fee Due
Arrear membership fees for 2017 should be paid before registering.
Please take NOTE our banking details have changed to Investec Bank Limited
Click for more info

Early Bird closed at midnight, Sunday, 28 Feb 2021

Preferred Name

Surname

Mobile (Country Code + Mobile)

Private Practice/Institution

Address 1

Address 2

City

Postal Code

Other Membership

Please indicate Membership for CPD:

MP AHPC HPCSA Other Not a Doctor

If Other specify Society Code:

Other Society Code or Acronym

* SA Doctors only (MP number, Mobile number and
Email address will be used on CPD certificate)

MP Number

Registration Requirements

Arrival Date:
Departure Date:

Will you attend the Social Gathering 19h30 ?
Yes No

Dietary Requirements

Specify Other

Disability Description

Accompanying Persons

Not attending Congress. Social function only.

Number of Accompanying Person(s):

Persons 1

Preferred Name

Surname

Will person attend the Social Gathering 19h30 ?
Yes No

Dietary Requirements

Specify Other

Persons 2

Preferred Name

Surname

Will person attend the Social Gathering 19h30 ?
Yes No

Dietary Requirements

Specify Other

Persons 3

Preferred Name

Surname

Will person attend the Social Gathering 19h30 ?
Yes No

Dietary Requirements

Specify Other

Persons 4

Preferred Name

Surname

Will person attend the Social Gathering 19h30 ?
Yes No

Dietary Requirements

Specify Other

Go to Pay Option

Add next Delegate

Go to Pay Option

Additional Info

You are paying in South Africa using ZAR (R)

Payments are processed by South African Spine Society Congress Account.

Please select Payment Options : Credit Card EFT secure instant deposit EFT manual

Terms & Conditions SA Spine Society

Marketing Permissions

Yes No    May we distribute your details to all the Exhibitors
Yes No    May we distribute your details to all the Delegates
Yes No    May we use your details for General SASS marketing
Yes No    May we share your details with the supporting companies

Back to Delegate

Finalise

I have read and understand the Terms of Use
Click to see Terms of Use

Description	Qty	Rate	Amount




		Total : R

After you have made a cost selection and all the relevant data is recorded
the Complete Registration button will appear

When prompted, allow pop-ups to enable the payment facilitation please
You will receive an invoice by email confirming your Registration.
A separate payment screen will open. If you do not want to proceed with the payment transaction click [Cancel]

20th Spine Congress: 20 - 22 May 2021

Century City Conference Centre, South Africa

Delegates

Payment : Self Sponsored

Payment : Self

Payment : Sponsored

Billing Info

Delegate Info

Payment Option

Confirm

Billing Info

Full Address

Contact Person

Delegate Info

Delegate No. 1

Other Membership

Please indicate Membership for CPD:

* SA Doctors only (MP number, Mobile number and Email address will be used on CPD certificate)

Registration Requirements

Will you attend the Social Gathering 19h30 ? Yes No

Accompanying Persons

Not attending Congress. Social function only.

Persons 1

Will person attend the Social Gathering 19h30 ? Yes No

Persons 2

Will person attend the Social Gathering 19h30 ? Yes No

Persons 3

Will person attend the Social Gathering 19h30 ? Yes No

Persons 4

Will person attend the Social Gathering 19h30 ? Yes No

Additional Info

You are paying in South Africa using ZAR (R)

Payments are processed by South African Spine Society Congress Account.

Please select Payment Options : Credit Card EFT secure instant deposit EFT manual

Marketing Permissions

I have read and understand the Terms of Use Click to see Terms of Use

I have read and understand the Terms of Use Click to see Terms of Use

When prompted, allow pop-ups to enable the payment facilitation please You will receive an invoice by email confirming your Registration. A separate payment screen will open. If you do not want to proceed with the payment transaction click [Cancel]

Payment :
Self Sponsored

* SA Doctors only (MP number, Mobile number and
Email address will be used on CPD certificate)

Will you attend the Social Gathering 19h30 ?
Yes No

Will person attend the Social Gathering 19h30 ?
Yes No

Will person attend the Social Gathering 19h30 ?
Yes No

Will person attend the Social Gathering 19h30 ?
Yes No

Will person attend the Social Gathering 19h30 ?
Yes No

I have read and understand the Terms of Use
Click to see Terms of Use

I have read and understand the Terms of Use
Click to see Terms of Use

When prompted, allow pop-ups to enable the payment facilitation please
You will receive an invoice by email confirming your Registration.
A separate payment screen will open. If you do not want to proceed with the payment transaction click [Cancel]