Liberty Protection Safeguards Conference Booking Form

Liberty Protection Safeguards

Liberty Protection Safeguards and the Frontal Lobe Paradox Conference
The conference will take place on Wednesday 15th September from 9am-4pm at Exeter Racecourse, Kennford, Exeter, EX5 7XS.

The prices are as follows:
- Individual delegates - £60 each
- Individual delegate plus flyers in delegate packs - £90
- Exhibition stand including one delegate place - £100 - SORRY EXHIBITION STANDS SOLD OUT
- Exhibition stand and flyers in delegate packs, plus one delegate place - £130 - SORRY EXHIBITION STANDS SOLD OUT
- Special rate for registered charities - £60 for the first delegate, £50 for each additional delegate from the same organisation
Delegate Name *

First Name Last Name
Role *
Organisation *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact number *

Area Code Phone Number
Email *
example@example.com
Can we include your name, organisation and email address on the delegate list? *

Yes No
Would you like to add another delegate?

Yes No

Delegate Name *

First Name Last Name
Role *
Organisation *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact number *

Area Code Phone Number
Email *
example@example.com
Can we include your name, organisation and email address on the delegate list? *

Yes No
Would you like to add another delegate?

Yes No

Delegate Name *

First Name Last Name
Role *
Organisation *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact number *

Area Code Phone Number
Email *
example@example.com
Can we include your name, organisation and email address on the delegate list? *

Yes No
Would you like to add another delegate?

Yes No

Delegate Name *

First Name Last Name
Role *
Organisation *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact number *

Area Code Phone Number
Email *
example@example.com
Can we include your name, organisation and email address on the delegate list? *

Yes No

Would you like to book promotional options for your organisation?

Yes please - leaflets in delegate packs Yes please - just an exhibition stand (SORRY, SOLD OUT) Yes please - an exhibition stand and leaflets in delegate packs (SORRY, SOLD OUT) No thank you
Do you have a health issue, disability or learning difficulty that you would like us to know about? If so, how can we assist you?
Do you have any special dietary requirements?
Invoicing details
(If different from above)
TERMS & CONDITIONS: Once your booking is received, confirmation of your place will be sent to you, together with further details and directions. If you are unable to attend you may send someone in your place. If you cancel with more than two weeks’ notice you will receive a full refund less £5 administration charge. If you cancel with less than two weeks’ notice, the full amount is payable. Headway Devon reserves the right to cancel or change the events. In the event of cancellation a full refund will be offered. In the event of cancellation, at least 14 days’ notice will be given, unless it is due to circumstances beyond our control.
I have read and agree to the Terms and Conditions *

Yes
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