Credit Card Guarantee Form

A maximum of two nights for 7-8 June 2018 of hotel accommodation is included in your BCa18 registration. Hotel reservations can only be processed upon receipt of your credit card guarantee. Your credit card would only be debited for €100 / night in case of no-show, late cancellation and less than 70% attendance rate during the congress. This will be monitored when scanning the badges. Please note: The reservation is not confirmed until this form is returned.

* is required field





Contact details
Company
First Name*
Title
Last Name*
Address*
Postal Code*
City*
Country*
Telephone
Mobile*
Fax
Email*
I hereby authorize Congress Consultants B.V., the EAU Congress Office, to debit the following credit card:
Type American ExpressVisaEurocard/Mastercard
Credit card no*
Expiry date*
CVC Code*
Name credit card holder*
I hereby agree to the terms and conditions*