ESP |

REGISTRATION FORM

The information provided will be confidential and used exclusively for accreditation, logistics and emergency response purposes during the event.

01. Personal data

*Photograph

Name

Surname

Email Address

Confirm Email Address

Country

gender

Phone

Type of identification

DNI/Passport

02. Institutional Data

This information allows the organization to coordinate the transfer and reception logistics in Tegucigalpa.

Name of your institution or organization

Sector of your institution or organization

Position held within your institution or organization

03. Travel itinerary and accommodation

This information allows the organization to coordinate the transfer and reception logistics in Tegucigalpa.

Tipo de ingreso

Land Air

Tipo de salida

Land Air

Accommodation in Tegucigalpa

04. Additional data

Select this option only if you have relevant medical information.

I have a relevant medical condition, ailment, or allergy that may require attention during the event.

05. Emergency contact

Full name of emergency contact

Email Address

Emergency phone contact

Relación con la persona participante

I declare that the information provided is truthful and I authorize the organizing entity of the XXIII Clarciev Honduras 2026 Meeting to use it for accreditation, logistics and emergency care purposes during the event..

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