Delegate Registration

Contact Details

Title

First Name

Last Name

Hospital/Organisation

Specialty

If OTHER, please specify your specialty

Email Address

Verify Email Address

Mobile Number

Dietary Requirements

Medical Council Registration Number (Complete with Council abbreviation followed by number for example: MP 0123456 or N/A. Please ensure this number is correct.)

Please ensure that the email address you have provided to the HPCSA is correct and functional in order to receive the HPCSA updates.

HPCSA #

Billing Address

Address Line 1

Address City

Province

Address Country

Address Postcode

VAT Number

TERMS & CONDITIONS

Payment is due three days from date of registration.
All payments must be made prior to the event.
Registration fees do not include travel, transfers or accommodation (unless highlighted in the registration document).
Once an online registration has been completed and submitted the ‘Cancellation’ terms, as listed below, apply.

INDEMNITY

Whilst the utmost care is taken by the meeting organisers, Organising Committee of 2025 CCSSA KZN Symposium and the venue, please be advised that these parties will not be held liable for any loss, damages or injuries sustained by any delegate whilst participating in the above event. All delegates are responsible for their own insurance.

CANCELLATION OF REGISTRATION

Notice of cancellation must be in writing and is subject to bank and administration charges. The reason for cancellation will be reviewed and a decision taken. All cancellations received after the 25^th of April 2025 will result in forfeiting their registration fees.

You're almost done!

Select your payment option below and click the SUBMIT button at the bottom of this page to complete your registration.

Payment

EFT PAYMENT:

Payment is due three days from date of registration

BANKING DETAILS:

Bank: ABSA

Account Name: Velocity Vision

Account Number: 4084677851

Branch Number: 632005

NB: Reference is CCSSAKZN + firstname + surname (eg: CCSSAKZN JOHN SMITH)

Proof of payment is to be emailed to accounts@velocityvision.co.za

ONLINE DEBIT / CREDIT CARD PAYMENT:

If you select the Online debit/credit card payment option, you will be directed to the Paygate page. Once payment has been processed, you will return to this page.

Please make sure you select the 'SUBMIT' button below to complete your registration.

IF YOUR ONLINE CARD PAYMENT IS UNSUCCESSFUL IT MAY BE THAT:

The transaction has been declined by your bank's 3D Secure authorisation system.

The cardholder has not entered their details correctly. This could be due to a mistyped card number, incorrect expiration date or CVV number.

If this continues you should contact your bank. Please be sure to inform them that your card was declined while trying to authorise a payment on Paygate via 3D Secure,
otherwise they may not be able to provide the best information to help with your purchase.

If you continue to experience problems paying by card, you can switch the payment method and arrange to pay by EFT.

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Data Processing Consent

Contact Details

Billing Address

Registration

Terms & Conditions

Summary

Payment

Thank You

Data Processing Consent

Contact Details

Billing Address

Registration

Terms & Conditions

Summary

Payment

Thank You

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