NEURO-OPHTHALMOLOGY FOR EVERYONE

Bologna – 24th January, 2020

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1 Step 1

Registration Form

Name

Surname

Date of Birth

Place of Birth

Email addressa valid email

DeparturePlease select the date you will arrive in Italy

ReturnPlease select the date you will leave Italy

Means of Transportation you prefer

AirplaneTrain

Airport/Railway Station of Departure

OtherComments

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Dears,

In accordance with the law on privacy (Legislative Decree 196/2003) I authorize the handling of the above information and I accept responsibility for omissions from or falseness of said data.

AgreeDeny

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Across Events has planned several formats throughout the years and all of them are characterized by a great drawing power and passion. Beyond-the-ordinary challenges, adrenalin, a strong social pride and a truly unique and captivating experience.

Via Bernardino da Feltre, 4
27100 Pavia
Tel. + 39 0382 576634
Fax + 39 0382 1753058
info@acrossevents.com

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