2018 World Modern Pentathlon Coaches Registration Form

The UIPM and Pentathlon GB are pleased to announce the launch of the 2019 World Modern Pentathlon Coaches Conference which will be held from 15th-17th November 2019. The event will be held at the Manchester Conference Centre for the 7th consecutive year.

Full Name*

First NameLast Name

E-mail*

Phone number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Arrival Date

Departure Date

Hotel Accomodation will be available on the evenings of Friday 15th, Saturday 16th and Sunday 17th November 2019 included in your accreditation fee. This year your accreditation fee will reflect the package you select. Please enter the dates below of the nights you require accomodation.

Delegates wishing to arrive earlier or depart later must arrange their own hotel booking for dates OUTSIDE the ones shown in options below

Accommodation Required*

Friday 15th ONLY (£130)Friday 15th and Saturday 16th ONLY (£260)Saturday 16th ONLY (£130)Saturday 16th and Sunday 17th ONLY (£260)Friday 15th, Saturday 16th and Sunday 17th ONLY (£375)

This option will give you a room on Friday, dinner Friday, breakfast Saturday, lunch Saturday - Delegate fee £130

This option will give you a room on Friday and Saturday only, dinner Friday/Saturday, breakfast Saturday/Sunday, lunch Saturday/Sunday - Delegate fee £260

This option will give you a room on Saturday only, dinner Saturday, lunch Saturday/Sunday, breakfast Sunday - Delegate fee £130

This option will give you a room on Saturday and Sunday only, lunch Saturday/Sunday, dinner Saturday/Sunday, breakfast Sunday/Monday - Delegate fee £260

This option will give you a room on Friday, Saturday and Sunday only, dinner Friday/Saturday/Sunday, lunch Saturday/Sunday, breakfast Saturday/Sunday/Monday - Delegate fee £375

1st Meal

Last Meal

Accreditation fee will be paid by*

Conference Accreditation fee must be paid by 1st October. The payment details are shown on the UIPM WMPCC Webpage

Please give details of who will be making payment*

Do you require Visa letter of official invitation*

Full name as shown in your Passport

Date of Birth

DayMonthYear

Nationality

Actual dates required for the Visa

Visa From (Start)

DayMonthYear

Visa To (End)

DayMonthYear

Passport Issue Date

DayMonthYear

Passport Expiry Date

DayMonthYear

Passport Number