Debriefing course registration

Contact information

First name *

Surname *

Preferred name *

Hospital/workplace *

Position *

If position is other please provide details:

Email address *

Postal address *

Phone *

Dietary requirements

Course date

Select your preferred date

10th September 2020

Method of payment

Once your completed registration form has been received you will be sent an invoice.

Select one of the options below

Invoice my employer (please give details below)

Invoice me personally

Employer

Terms and conditions

We reserve the right to cancel any course if the minimum number of attendees is not met, or due to circumstances beyond our control. Under those circumstances we will refund any course payments. In the event of participant cancellation up to 4 weeks prior to the course date, course registration fees will be refunded, less an administration fee of $250. If a participant fails to attend the course or cancels less than 4 weeks prior to the course date, no refund will be issued, except under exceptional circumstances as determined by management. All cancellations must be made by email to the Simulation and Skills Centre (wrcsse@ccdhb.org.nz).

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