Register - SAUA 2021

E-mail or fax proof of payment to saua2021@rkcommunication.co.za or + 27 (0) 86 60 60 555.
Please ensure that you receive a confirmation by e-mail from the organisers within 10 working days.
Important request to companies sponsoring delegates:
Kindly let us have the delegate’s personal postal address and other contact information.

Some of the compulsory fields are not completed or invalid, please correct and try again.

Registration Category *

Personal Details

Surname *

First Name *

Initials *

Title *

Badge Name * Preferred badge name of delegate.

HPCSA Number

ID/Passport Number *

Company/Institution *

VAT Number

Business Telephone Number *

Business Fax Number

Mobile Number *

Email Address *

Postal Address *

City/Town *

Postal Code *

Province *

Country *

Do you have any special
dietary requirements?

Accommodation

You are responsible for your own accommodation arrangements.

Accommodation *

Registration

SAUA members
Fully paid-up SAUA members

Non-members

Registrars, MOs & GPs

Nurses

Free trade delegate
Free Trade Delegate / Exhibitor: The two free delegates per exhibition stand. Registered representative in the service of a company participating in the trade exhibition.

Additional trade delegate
Additional Trade Delegate / Exhibitor: Refers to the additional trade delegates / exhibitors registered after the two free delegates per exhibition stand.

Which days will you attend? *

Full Attendance

Friday, 29 October

Saturday, 30 October

Sunday, 31 October

Pre-congress Workshops

Which workshops will you attend?

Workshop 1 - Urethroplasty
Tuesday, 26 Oct (08:30 – 17:00)

Two parallel workshops

Workshop 2 - Hypospadia & Paediatric Urology Masterclass
Wednesday,27 Oct (08:00 – 17:00)

Workshop 3 - Laparoscopic skills
Wednesday, 27 Oct (08:00 – 17:00)

Workshop 4 - HoLEP
Thursday, 28 Oct (08:00 – 12:00)
(Parallel to Robotic Surgery Masterclass at Monte Bello Estate)

Please click here for more information regarding the Workshops & Masterclasses

Masterclasses

Which Masterclasses will you attend?

Masterclass 1 - Robotic Surgery
Thursday, 28 Oct (08:30 – 12:30)
(Parallel to HoLEP Workshop at the UFS)

Two parallel masterclasses

Masterclass 2 - Uroradiology & Ultrasound
Thursday, 28 Oct (13:15 – 17:00)

Masterclass 3 - Urogynaecology & Urodynamics
Thursday, 28 Oct (13:15 – 17:00)

Social Functions

Will you attend the Welcoming Function, Thursday, 28 October? *

Yes

Will you bring an unregistered guest(s) with? *

Yes

Additional Unregistered Guests @ R350 each*

Will you attend the Vrystaatopskop/Mokete/Jamboree, Friday, 29 October? *

Yes

Will you bring an unregistered guest(s) with? *

Yes

Additional Unregistered Guests @ R 490 each*

Will you require a shuttle to/from function venue? *

Yes

Will you attend the Gala Dinner & Awards, Saturday, 30 October? *

Yes

Will you bring an unregistered guest(s) with? *

Yes

Additional Unregistered Guests @ R 490 each*

Will you require a shuttle to/from function venue? *

Yes

Accompanying Person's Programme

Will your accompanying person take the Bloemfontein City Tour , Friday 29 October? *

Yes

Number of Guests @ R600 each*

Will your accompanying person take the Big Hole & Magersfontein Battlefield Tour, Saturday 30 October? *

Yes

Number of Guests @ R900 each*

Accompanying Person's Details

First Name *

Surname *

Mobile Number *

Shuttle Service (Free)

Will you use the shuttle service from airport to 2 hotels/venue? *

Yes, on Tuesday, 26 October

Yes, on Wednesday, 27 October

Yes, on Thursday, 28 October

Arrival Details

Arrival Date

Arrival Time

Arrival Flight Number

Will you use the shuttle service from Monte Bello to airport on Sunday, 31 October? *

Yes

Departure Details

Departure Date

Departure Time

Departure Flight Number

Payment Details

Method of Payment *

Responsible for Payment *

Registration Fee

Functions

Workshops & Masterclasses

Accompanying Person's Programme

Shuttle

Discount

Total Due

By submitting this Registration Form you agree that you are personally responsible for full payment of congress registration fees in the event that your company or organisation does not pay them.

Some of the compulsory fields are not completed or invalid, please correct and try again.