Formulaire d'inscription 15 november 2025

"Les soins entre performance et robustesse"

Please register here for our symposium (15 nov 2025)

E-mail address *

FIRST NAME of the participant *

FAMILY NAME of the participant *

Street & number *

Postal Code *

Town *

Country *

Please indicate your category *

100 euro (medical doctor)

60 (other profession)

30 euro if < 35 years old (young medical doctor or student)

I received a promotional code, and I mention it below

Promotional code *

Payment instructions : please make your payment via bank transfer : BE22 4376 1125 6147 (Belgian Medical Association Saint-Luke) mentioning "your name - nov 15 Namur" *

FULL REGISTRATION (whole day with lunch)

PARTIAL REGISTRATION: morning session

PARTIAL REGISTRATION: lunch

PARTIAL REGISTRATION: afternoon session

Do you need simultaneous translation (headset)? *

Oui, je voudrais suivre une traduction simultanée vers le français

Ja, ik wens simultane vertaling te volgen naar het Nederlands

No / geen vertaling nodig / traduction non nécessaire

Would you like to register another person? *

no

yes, I will submit a new registration form for the other person

Do you have any other comment? (or mail to president@cathmed.be)

Registration St-Luke Symposium 15 nov 2025 Namur