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My Details
Program
Social
Confirmation

RACS ID

Please ensure you enter your 6-DIGIT RACS ID NUMBER - this will determine your registration category.
If your ID is entered incorrectly or not at all, you will be charged at the full registration rate.

Name

Prefix

First Name

Last Name

Preferred Name (for Name Badge)

First Name

Last Name

Hospital/Organisation Name (for Name Badge)

Address 1

Address 2

Suburb

State

Postcode

Country

Email Address

Confirm Email Address

Preferred Phone Number

Dietary Requirements

I agree to have my name, hospital and suburb listed on the Delegate List

I have read and agree to the Terms and Conditions Including Dietary Requirements Policy*

Registration Category: Standard

Trainees' Day Thursday 17 October

$110^.00

3 Day ASM Registration 3-day program registration: FRI, SAT & SUN

$1,100^.00

Early Bird Pricing

2 Day ASM Registration Two-day program registration

Select your two days

Friday

Saturday

Sunday

$880^.00

Early Bird Pricing

1 Day ASM Registration One-day program registration

Select one day

Friday

Saturday

Sunday

$495^.00

Registration Category: Standard

Trainees' Dinner Thursday 17 October

$88^.00

Welcome Reception Delegate Ticket - must be registered for Friday program

$0^.00

Welcome Reception - Additional Friday 18 October

Number of Tickets

$66^.00

Welcome Reception - Children's Ticket recipient must be 13 & under

Number of Tickets

$22^.00

Saturday 19 October Social Spectacular

Number of Tickets

$130^.00

Early Bird Registration

RACS ID

Name

Preferred Name (for Name Badge)

Dietary Requirements