ࡱ> Z\Y%` bjbjٕ 4L:K:::8rD/F:[[[f/h/h/h/h/h/h/$0h;3`/1"[[1"1"//u$u$u$1"f/u$1"f/u$u$V+@,: ]ֱ:"v", j-/0/.,T35#3,3,[du$[[[// $j[[[/1"1"1"1"$  Name: ________________________________________________________________ Address: ______________________________________________________________ ______________________________________________________________________ __________________________________ Postcode: __________________________ Telephone: ____________________________________________________________ E-mail address: ________________________________________________________ Date: _________________________________________________________________ Conference Fees (excluding accommodation) The NPDG (UK) substantially subsidises fees to families. The Weekend Delegate Rate includes refreshments, buffet lunch and dinner on Saturday, refreshments and buffet lunch on Sunday. There are no fees for children under the age of five years. Weekend Delegate RatesAdultChildAffected Individual All individuals affected by N-PDNo FeeNo FeeImmediate Family RateParents, step-parents, siblings, partners or spouses and children of affected individuals.20.005.00Extended Family Rate All other family of affected individuals30.007.00Standard / Professional Rate Everyone else60.0010.00Day Delegate rates are available on request, please contact Toni Mathieson on 0191 415 0693 or email  HYPERLINK "mailto:niemann-pick@zetnet.co.uk" niemann-pick@zetnet.co.uk We would like to attend the NPDG (UK) Family Conference 2007: AdultsConference FeeChildrenConference Fee Sub totalSub totalPlease make cheques payable to: NPDG (UK) Total Payable: _______________ Do you have any specific dietary requirements? Yes / No Please specify: __________________________________________________________ If you are attending this conference as a professional, please state your profession: ___________________ Limited funds are available for those families needing help with expenses. All applications are treated in confidence. Please contact us for more information. Children and Young Adults Programme I would like my child / children to participate in: A. Crche and Childrens Programme B. Young Adults Programme Signed (Parent / guardian) _______________________________________ I am over 16 and would like to participate in the Young Adults Programme. Signed________________________________________________________ Further details of the Activity Programmes will be sent to you on receipt of this form. Carers If you need a carer to enable you to attend the Conference, the NPDG (UK) will pay their costs (registration, accommodation, and travel expenses). We will send out a separate carers form on receipt of your booking form. Will you be bringing a carer? If so, please tell us their name: ______________________ Hotel Accommodation The conference venue this year is the Hilton Hotel East Midlands Airport. If you require accommodation please complete the information below or contact us at the NPDG (UK) office: 0191 415 0693 or email:  HYPERLINK "mailto:niemann-pick@zetnet.co.uk" niemann-pick@zetnet.co.uk and we will book it for you. The Hilton have generously offered a special Bed and Breakfast rate of 37.00 per person (single supplement 15.00) to those attending the Conference. There will be no accommodation charge for children under 16 years sharing a room with their parents. All accommodation charges are to be settled by the individual delegate on departure. Do you require accommodation? Yes______ No______ If yes, please complete the following information indicating the number and type of room required: Friday 27th June Single Room___ Twin___ Double___ Family___ Saturday 28th June Single Room___ Twin___ Double___ Family___ Smoking_____ Non-Smoking_____ There are a restricted number of specially adapted rooms available for disabled users. If you require one of these rooms please indicate here: Yes______ No______ The closing date for Conference bookings is 6th June 2008. Please book early to avoid disappointment. If you have any queries or would like help completing this form please contact Toni Mathieson on 0191 415 0693 or email  HYPERLINK "mailto:niemann-pick@zetnet.co.uk" niemann-pick@zetnet.co.uk Please return your completed forms to: Niemann-Pick Disease Group (UK) 11 Greenwood Close Fatfield, Washington Tyne and Wear, NE38 8LR     Niemann-Pick Disease Group (UK) Conference 2008 Booking Form     * + I }  ! 8 9 E   Ƚqq_N_N@hCJOJQJ^JaJ h)XhCJOJQJ^JaJ#h)Xh5CJOJQJ^JaJh zCJOJQJ^JaJhCJOJQJ^JaJ hhCJOJQJ^JaJh zCJOJQJ^JaJ h` h zCJOJQJ^JaJh z5OJQJ^Jh zh5OJQJ^Jh)XCJOJQJ^JaJh^CJOJQJ^JaJh/^CJOJQJ^JaJHI$ % m n  + ! 8 9 ? 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