International registration

1 Membership

Are you an ISL member? *

Yes No

2 Personal details

Title *

First name *

Last name *

Name on badge *

Gender *

Age *

3 Contact

Email *

Mobile *

4 Professional details

Professional license / registration no. *

Country of registration *

Institute / Hospital name

5 Postal address

Address

Country *

State / Province *

City *

Postal / Zip code *

6 Registration & fees

Registration package *

Early-bird international rates (USD). Equivalent INR is shown for bank transfer. Rate: 1 USD = ₹83.5.

Conference registration Doctors / Physicians ISL Member: $400 Non Member: $450 Conference registration Physiotherapists / Nurses / Residents and PG students ISL Member: $325 Non Member: $375 Combined package Registration + accommodation — Doctors / Physicians ISL Member: $850 Non Member: $900 Combined package Registration + accommodation — Physiotherapists / Nurses / Residents and PG students ISL Member: $800 Non Member: $850

Delegate category *

Estimated total

Package (USD)	—
Bank transfer (INR)	—
Total USD	—
Total INR	—

7 Terms & conditions

I confirm that the information provided is accurate. I agree to the congress terms & conditions and understand that registration is subject to verification.

You will review bank payment details on the next step.