EPNS Masterclass 2026 Registration form for Two People 1150 Euros

COMPLETE THIS FORM to register for TWO people to attend the EPNS Masterclass with accommodation included (1150 Euros)

Delegates are encouraged to register as a “couples”; a senior mentoring clinician and a mentee/leader of tomorrow. Couples do not necessarily have to work at the same hospital but must have a mentor/mentee connection.

You are completing this form for a “couple”, i.e. for 2 people as a mentor/mentee couple

If instead you would like to register for one person only, you are most welcome. Please complete the form entitled 'EPNS Masterclass 2026 Registration form for One Person'

All fields marked (*) are mandatory.

MENTOR (senior mentoring clinician) information

Mentor Title(*)

Mentor First name(*)

Mentor Last name(*)

Mentor Email(*)

Mentor Mobile Telephone Number(*)

Mentor Work Address(*)

Mentor Country 1(*)

MENTEE (young leader of tomorrow, suggested under 45 years old, with a clinical practice in paediatric neurology and active in research and teaching) information

Mentee Title (*)

Mentee First name (*)

Mentee Last name (*)

Mentee Email (*)

Mentee Mobile Telephone Number (*)

Mentee Work Address (*)

Mentee Country (*)

MENTOR and MENTEE Masterclass information

Will you be attending the optional social event on Thursday 17 September 2026 for an extra cost of 70 Euros per person? (Museum of Zoology and dinner at the Eagle pub)? Note: drinks at The Eagle are NOT included in this price. Guests need to purchase their own drinks from the bar (*)

Will you be attending the conference dinner on Friday 18 September 2026 at Corpus Christi (this is included in the registration fee)? (*)

Do you have any special dietary requirements? (*)

If special dietary needs, please give details ...

Do you have any special needs (e.g. wheelchair, etc.)? (*)

If yes, please give details ...

We are both EPNS members and we have BOTH paid our 2026 EPNS Membership fees (MANDATORY. Will be verified) (*)

We understand the registration fee of 1150 Euros includes FOR 2 PEOPLE: accommodation for 3 nights (16,17,18 September 2026) at either at Corpus Christi or St Catharine’s College in an en-suite single room and that these are student rooms and can be quite basic (*)

We will need accommodation for additional nights (cost 120 Euros per night PER PERSON) (*)

If yes, please give details ...

How will you be paying? Payment details will be sent in the automatic acknowledgement email.(*)

We have read, understood and accept the EPNS Masterclass Terms and Conditions (*) [+]

We understand to confirm this reservation, we must pay the registration fee (plus fee for extra nights accommodation and Thursday social evening event if applicable).(*)