Please enable JavaScript in your browser to complete this form. - Step 1 of 3TERMS & CONDITIONS - COMPULSORY TO READ BY REGISTERING FOR THE COMPANION PROGRAMME, YOU ARE AGREEING TO THE FOLLOWING TERMS & CONDITIONS: NOTE: Should there be a COVID outbreak, there will be a full refund. 1- Invoices or quotations, if requested, will be emailed within 72 hours of registration. 2- Registration fees are to be paid in full prior to Conference. 3- Non-payment will result in access being denied to the Companion Programme. 4- Participants attending from outside South Africa are requested to make payment in South African Rands (ZAR). 5- Proof of payment, with the invoice number as beneficiary reference, is to be emailed to: finance@imesa.org.za 6- Registered Companions who are unable to attend and cancel within 21 days of the Conference, will be charged a cancellation fee of R750. 7- Registered Participants who fail to CANCEL in writing prior to the Conference, will be liable for the FULL FEE. 8- If a Registered Participant cannot attend the Programme, a name change can be requested in writing via registration@imesa.org.za It is the Participants responsibility to ensure IMESA has the correct EMAIL ADDRESS as at 01 October 2023 for Companion Programme updates and recording of attendance. Please notify conference@imesa.org.za if your email changes. I hereby confirm that I have READ AND AGREE to the Terms and Conditions of this Agreement as set out above which includes the cancellation and payment conditions. *YESNextDate of making this booking *BILLING INFORMATION This information will be used to generate an Invoice. Name / Company Name to appear on Invoice *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryVAT Number (if applicable)Name of person responsible for paying the account *FirstLastLayoutEmail *Phone *NextCOMPANION DETAILS We will use this information for all correspondence related to the Programme. Name *FirstLastLayoutPhone *Preferable a Cell Number Will you be attending the OPENING FUNCTION? *YesNoN/A(Tuesday, 24 October 2023 - incl. in Fee)Attending lunch at venue on Friday, 27 October 2023? *YESNOEmail *Enter valid email addressWill you be attending the SOCIAL EVENING? *YesNoN/A(Thursday, 26 October 2023 - incl. in Fee)DIETARY & ALLERGY DETAILS This will assist us with catering. LayoutMeal Preferance *VegetarianNoneDo you have any allergies? *YESNOIf YES, what are they?Submit