Midnight Sun 2022
General Information
Full Legal Name
Professional Credentials
Date of Birth
Cell Phone
I will attend the event for the full 3 days
Email Address
Name of Workplace

I will need a support letter provided by Kerecis to report my hospital/work administration

If yes: Please provide the address of the hospital and whom the letter should be addressed to
What is the case you will be presenting at the event

Will you need any assistance from Kerecis' Medical Writer to put the case together?
Kerecis Representative
Travel Details
I will be traveling alone
If no: Who will be joining you?
I will start my travel from
Name of airport
Other (Please write here if you have any allergies or special dietary wishes)

the Terms and Conditions

For all invited doctors and medical professionals; standard fare air travel, meals and lodging are covered by Kerecis for the duration of the workshop. While family members and/or spouses are not included, we can assist in making travel arrangements. We’ll do our best to accommodate their needs, and assist them in scheduling sightseeing and experiencing Iceland. If you’re having problem completing the form please contact events@kerecis.com