47th Annual Meeting of the DIABETIC PREGNANCY STUDY GROUP Málaga, 1-4 Oct.2015 Send completed form to: Fundació DIABEM (email: dpsg2015@fdiabem.org). Each delegate attending the meeting should fill out a form. Proof of bank transfer or credit card details should accompany the registration form. Deadline for receipt is 1 st August 2015 Full Name: Affiliation Address: Telephone: E-mail: DPSG Member: Ordinary Honorary/International Associate Non Member REGISTRATION FEES (VAT included) (Please mark your preferred option with X ) OPTION 1) ACCOMMODATION AT PARADOR MALAGA-GOLF Please note that DPSG Members have preference to book a room in the Parador until the end of the early registration deadline on 31 st of May. After this deadline, if there are still rooms available at the Parador, any delegate can book a room, on a first-come, first-served basis.
DPSG 1-4 OCT.2015 FEES Early bird Registration (before 31 st May 2015) *Delegate attending alone 534 635 *Delegate with one accompanying person *2 Delegates sharing one room Delegate + 1 adult + 1 Child (under 12 years old) sharing one room Delegate + 2 people sharing one room 810 for both persons 830 (415 each delegate) Late Registration (After 31 st May 2015) 880 for both persons 910 (455 each delegate) 990 1.090 1.225 1.325 Extra charge (superior room) 50 /day 50 /day *Including: admission to the scientific sessions, accommodation at the Parador (1-2-3 Oct), lunches (2-3 Oct), dinners (1-2-3 Oct), coffee breaks, conference printed materials Sharing room with: (delegate) Accompanying person s name(s): ADDITIONAL DAY (room & breakfast) *Delegate attending alone: 110 /day *Delegate with 1 accompanying person: 125 /day *2 Delegates sharing one room: 125 /day Delegate + 1 adult + 1 Child (under 12 years old) sharing one room: 145 /day Delegate + 2 people sharing one room: 193 /day Extra charge (superior room): 50 /day TOTAL AMOUNT (DPSG Attendance + Additional Days): OPTION 2) DELEGATE WITH OTHER ACCOMMODATION ARRANGEMENTS (TRYP GUADALMAR HOTEL OR OTHER OPTIONS) DPSG 1-4 OCT.2015 FEES Early bird Registration (before 31 st May 2015) Late Registration (After 31 st May 2015) **Delegate with other 235 235 accommodation arrangements **Including: admission to the scientific sessions, lunches (2-3 Oct), dinners (1-2-3 Oct) and coffee breaks at the Parador, conference printed materials
Fees for accompanying person of delegate not staying at the Parador, but who would like to have dinner, lunch and coffee break at the Parador during the meeting: FEES FOR ACCOMPANYING PERSON NOT STAYING AT THE PARADOR Lunches (2-3 Oct), dinners (1-2-3 Oct) and coffee breaks Early bird Registration (before 31 st May 2015) 213 213 Late Registration (After 31 st May 2015) Lunches (2-3 Oct), dinners (1-2-3 Oct) 201 201 Dinners (1-2-3 Oct) 123 123 TOTAL AMOUNT (Delegate + accompanying person not staying at the Parador) Please note: if you are not staying at the Parador, you must pay the registration fee to the Parador (235 ), AND pay the accommodation fees (room & breakfast) directly to TRYP Guadalmar Hotel, Hotel Málaga Picasso, Holiday Inn Express Málaga Airport or to any other hotel of your choice. For delegates not staying at the Parador, special accommodation rates have been secured at Hotel TRYP Guadalmar****, which is at a short distance from the Parador. ACCOMMODATION AT TRYP GUADALMAR HOTEL**** Rates per room and day incl.breakfast Total for 1-4 Oct. (3 nights) Double room 85 255 Single room 80 240 Children (under 8 years) Free Children (over 8 years) Supplement of 40 Website: http://www.tryphotels.com/en/tryp-guadalmar-hotel-malaga-spain.html Contact person: Eva Piñero comercial.guadalmar@melia.com Tel. (34) 952 231703 - FAX. (34) 952 240385 (Identify yourself as a DPSG delegate) ACCOMMODATION AT MÁLAGA Rates per room and day PICASSO HOTEL*** Double Room 74.52 Single Room 69.12 Junior Suite 92.88 Senior Suite (4 people) 167.40 Extra bed (children less than 14 years) 35% of room rate Buffet breakfast 7,56 per person, children less than 14 years: 5,40 From Easter until the end of October Saturday Night + 5.40 per room
Website: http://hotelmalagapicasso.com/ E-mail: info@malagahotelpicasso.com Tel.: (+34) 952 176 061 Fax: (+34) 951 987 059 ACCOMMODATION AT HOLIDAY INN Rates per room and day incl.breakfast EXPRESS MALAGA AIRPORT*** 1 st Oct.2015: Single Room/Double Room 57 Rate is fully pre-paid, nonrefundable and non-cancelable or 67 Normal rate with free cancellation up to the day of arrival until 4 pm 2 nd & 3 rd Oct.2015: Single Room/Double 62 Rate is fully pre-paid, nonrefundable and non-cancelable Room or 72 Normal rate with free cancellation up to the day of arrival until 4 pm Website: http://www.ihg.com/holidayinnexpress/hotels/us/en/malaga/agpap/hoteldetail?cm_m mc=googlemaps-_-ex-_-esen-_-agpap E-mail: express.malaga@continentalhotels.eu Tel.: +34 952 248 500 Fax: +34 952 248 505 Please make sure you book your accommodation directly with the hotel of your choice. Hotel selected: SPECIAL REQUIREMENTS (MEDICAL & DIETARY) Should you have any special requirements (medical & dietary), kindly indicate: PAYMENT Registration fees are to be paid in (Euro) directly to the Parador Málaga Golf by bank transfer or by credit card. Registration will only be confirmed upon full payment. Details of payment to the Parador Málaga Golf via bank transfer, for: Delegates staying at the Parador Málaga Golf Delegates with other accommodation arrangements (the registration fee of 235 to be paid to the Parador includes the admission to the scientific sessions, lunches (2-3 Oct), dinners (1-2-3 Oct), coffee breaks and conference printed materials) PARADOR MALAGA GOLF IBAN: ES83 2103 0275 1400 3000 3342 Bank name: UNICAJA SWIFT code: UCJAES2M
Please, write your name under payment details. Please ensure that any bank charges are paid at source and not included in the amount forwarded. Proof of bank transfer (scanned document in pdf or jpg format) needs to be e-mailed to dpsg2015@fdiabem.org within 3 working days. If a company/institution is paying for your costs, don t forget to have them indicate your name in the memo so we can easily identify the payment. Payment with credit card: Credit card Name and surname: Credit card No: Valid: AMERICAN EXPRESS DINERS MASTER VISA CVC code: CANCELLATION Notification of cancellation must be made in writing and sent by email to dpsg2015@fdiabem.org. Total refund of registration fee will be provided for cancellation before 1st August 2015. Partial refund of registration fee (25%) will be provided for cancellation from 1st August to 1st September. No refunds will be given after September 1st. Modification of accommodation dates, cancellation and no show at TRYP Guadalmar Hotel, Hotel Málaga Picasso, Holiday Inn Express Málaga Airport will be handled accordingly with each individual hotel policy. EXCURSION TO MÁLAGA CITY, NERJA AND/OR GRANADA In case you are interested in attending the specially designed pre and post Congress tours to Málaga city, Nerja (with visit to the Nerja Caves, the town of Frigiliana and lunch at the Parador of Nerja) and Granada (with visit to the Historical-Artistic Monumental Complex of the Alhambra and the Generalife and lunch at the Parador of Granada, located inside the Alhambra), please let us know, so that we can calculate the fees per person and provide you with a quote. I m interested in: Excursion to Nerja. Number of accompanying people:. I prefer to attend the trip on 30 th September or 4 October. Excursion to Granada. Number of accompanying people:. I prefer to attend the trip on 30 th September or 4 October.
Excursion to Málaga city. Number of accompanying people:. I prefer to attend the trip on 30 th September or 4 October. Date: Signature: