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Event Registration: Ambulation, Activity and AFOs
Thank you for your interest in this course. We are delighted to have you join us!
Please ensure you have paid the appropriate fee before submitting this form.
Contact Clara Caplice at
clara.helpinghands@gmail.com
with any queries
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Contact email address
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Your answer
Name
*
Your answer
Discipline
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Physiotherapist
Orthotist
Other:
Clinical Population for the majority of your caseload relevant to this course (used to assign breakout rooms to facilitate more clinically useful discussions)
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Early Intervention (under 6s)
Paediatrics age 5-18
Adults (athletes, general musculoskeletal)
Adults with complex needs (neurology, disability)
Older adults
Equal mix/high variety of caseload
How did you hear about this course?
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ISCP website
Clinical Interest Group
Email from a colleague/friend/manager
Directly from Host (Helping Hands Physiotherapy)
Other:
Required
Will you be attending in person or virtually?
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In person €425 fee
Via Zoom €300 fee
Confirm that you have transferred the fee of €425 if attending in person or €300 if attending virtually
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By Bank Transfer marked as "AFO [FULL NAME]" (IBAN: IE30IPBS99060531294500 BIC: IPBSIE2D Bank: Permanent TSB Rathmines Name: Helping Hands Physio)
By Revolut marked as "AFO [FULL NAME]" (username: @clara5zoq Name: Clara Caplice)
Other:
Required
Would you like to receive details of other courses organised by Helping Hands Physiotherapy by email?
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Yes please keep me informed of upcoming courses by email
Please do not contact me about future courses
Contact mobile number (for on-the-day emergencies)
Your answer
Any dietary requirements or food allergies? If so, please specify in "Other".
NB it is your responsibility to fill this correctly, and if it is answered in error, to inform the host well in advance of the course so that your needs can be facilitated by the venue.
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No
Other:
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