Midwifery Today Conference
“Midwives Hold the Future”
Bury St. Edmunds, UK • 26–30 May 2014
Registration Form

1. Name and Address

Please print.

First Name
Last Name
Name to appear on badge (if different)
Street Address / P.O. Box
City
State / Province
ZIP / Postal Code
Country
Telephone
Fax
E-mail Address

Sex: _________ (for room sharing)

How are you involved in birth?

  •  Direct-entry midwife
  •  Licensed midwife
  •  Certified nurse-midwife
  •  Student midwife
  •  Aspiring midwife
  •  CPM
  •  RN
  •  Naturopath
  •  Childbirth educator
  •  Doula / LA
  •  Midwife educator
  •  Other _____________________________________

How many births have you attended? _________

How did you hear about this conference?
What excites you about this conference?

Do you give permission for Midwifery Today to release your name and address to fellow registrants?

  •  Yes
  •  No

2. Class Selection

I will attend classes on these days (select all that apply):

  •  Monday Pre-Conference, 26 May 2014
  •  Tuesday Pre-Conference, 27 May 2014
  •  Wednesday Conference, 28 May 2014
  •  Thursday Conference, 29 May 2014
  •  Friday Conference, 30 May 2014

Please tick off each class you will attend. Select one class from each set of concurrent sessions offered on the days you will attend. For example, if you will attend the conference on Wednesday, you need to select one class from C1 through C5 and also one class from D1 through D5. Class descriptions can be found in the conference program.

Monday: Pre-Conference

Select a full-day course (10:15 am – 5:00 OR 5:30 pm—see program for times):

  •  A1
  •  A2
  •  A3
  •  A4

Tuesday: Pre-Conference

Select a full-day course (10:15 am – 5:00 OR 5:30 pm—see program for times):

  •  B1
  •  B2
  •  B3
  •  B4
  •  B5

Wednesday: Conference Day One

Select one class (1:00 pm – 2:30 pm):

  •  C1
  •  C2
  •  C3
  •  C4
  •  C5

Select one class (2:45 pm – 4:15 pm):

  •  D1
  •  D2
  •  D3
  •  D4
  •  D5

Thursday: Conference Day Two

Select one class (10:45 am – 12:15 pm):

  •  E1
  •  E2
  •  E3
  •  E4
  •  E5

Select one class (1:30 pm – 3:00 pm):

  •  F1
  •  F2
  •  F3
  •  F4
  •  F5

Select one class (3:30 pm – 5:00 pm):

  •  G1
  •  G2
  •  G3
  •  G4
  •  G5

Friday: Conference Day Three

Select one class (10:30 am – 12:00 pm):

  •  H1
  •  H2
  •  H3
  •  H4
  •  H5

3. Subscribe to Midwifery Today  [ Optional ]

Subscribers to Midwifery Today are eligible for reduced conference prices. If you are not currently a subscriber, you can obtain registration discounts by subscribing at this time. Midwifery Today is an English language publication, published four times per year. Each issue contains 72 pages of articles, stories, and opinions, written by midwives and other birth practitioners from around the world.

AddressPrice for 1-year subscription to Midwifery Today
United StatesUS $55------
CanadaUS $68------
InternationalUS $75£45€55

If you would like to subscribe to Midwifery Today, please select the appropriate box below and enter your subscription price in the Payment section of this form.

  •  Please begin my subscription.
  •  Please renew my subscription.
  •  I am already a subscriber.

4. How to Determine Conference Prices

  1. Conference registration prices do not include meals, transportation or overnight accommodations. Separate fees for accommodations and meals are listed below. Look up your price in the table in Section 5, Conference Prices and Payment.

  2. By registering early, you become eligible for reduced conference prices. The early registration deadline is 7 April 2014. Prices are shown in the table below. Payment must be made by deadline to be eligible for reduced prices.

    Conference prices are determined by the postmark date on your registration. If you submit your registration by telephone, fax or e-mail, the postmark date will be deemed to be the date that Midwifery Today receives your communication. Payment must be made by the deadline to be eligible for reduced prices.

    Walk-in registrants pay the price listed in the table for 12 May 2014 when they arrive at the conference.

  3. If you are eligible for one of the special discounts described on the registration form below, tick the appropriate box and adjust the prices as directed.

    Discounts

    10% Subscriber Discount

    If you are a subscriber to Midwifery Today, you may deduct 10% from your conference registration price. Subscription may be started at time of conference registration, but must be current at time of registration to qualify for discount. Midwifery Today magazine is an English language publication. Student discount does not apply to subscription prices.

    20% Student Discount

    If you are a full-time student, you may deduct 20% from your conference registration price. You must register for three or more days; and you must submit, with your registration, proof of full-time student status. Student discount does not apply to subscription or room and meals prices.

    If you qualify for a discount, please select the appropriate box below and enter the amount of your discount in the Payment section of this form.

    •  Subscriber  [ 10% ]
    •  Full-time student  [ 20% ]
    •  Subscriber and full-time student  [ 30% ]
  4. Prices are subject to change in the event of large currency fluctuations. Prices shown in the table below are current prices.

  5. Discounts apply to conference registration prices only, not to subscription or room and meals prices.

5. Conference Prices and Payment

Conference registration prices:

Attendance Arrive in office by
12 May 2014*
1 dayUS $170£105 † €140 †
2 daysUS $340£210 † €280 †
3 daysUS $450£280 † €370 †
4 daysUS $620£385 † €510 †
5 daysUS $670£420 † €560 †
† Please select the price in U.S. dollars when you pay by credit card.

*Walk-in registrants are welcome, but you should check with Midwifery Today to learn the availability of classes. When you arrive at the conference, simply pay the price listed in the table for 12 May 2014.

Room and meal prices:

Shared room per night: $65; £42; €50

Private room per night: $115; £72; €85

Room and meal price includes breakfast, lunch, dinner and overnight stay. Each room has a shared bathroom with shower, washbasin and toilet. Bed linens are provided but please bring your own towel. Rooms and studios are available from 3:00 pm and check-out time is 10:00 am.

Important: Conference registrants who choose not to stay at the school are required to get approval from the conference coordinator at conference@midwiferytoday.com. Attendees not staying onsite will be required to purchase a meal card for 15 pounds per day.

I/we will be staying at Culford School these nights (select all that apply):

  •  Sunday, 25 May 2014
  •  Monday, 26 May 2014
  •  Tuesday, 27 May 2014
  •  Wednesday, 28 May 2014
  •  Thursday, 29 May 2014
  •  Friday, 30 May 2014

If you would like to share a room with someone, please write their name(s) here:

_______________________________________________________________
(If no roommate is specified, a same-sex roommate will be assigned randomly.)

If you are booking for others besides yourself, please list name and sex for each here:

_______________________________________________________________

_______________________________________________________________
(They will be roomed with you unless otherwise specified. Please include payment for your party in the table below on the shared room line. Please indicate the nights they are staying if different from you, above.)

Booking: Reservations are made through Midwifery Today, not Culford School. List your room preference and number of nights in the calculation table below.

Enter your conference price from the table above. 
If you qualify for a discount (see the Discounts section above), enter the amount of your discount (multiply your conference price by 10%, 20% or 30%). Enter 0 if you do not qualify for a discount. 
 
Subtract your discount from your conference price. 
If you are subscribing to Midwifery Today (see the Subscription section above), enter your subscription price. Enter 0 if you are not subscribing at this time. 
Shared room price × nights staying × number of people 
Private room price × nights staying 
TOTAL PAYMENT: Add the 4 lines above to calculate your total payment. 

How will you make your payment? NOTE: Credit cards will be charged in U.S. dollars.

  •  Check in sterling
  •  Check in U.S. dollars
  •  Bank transfer in sterling
  •  Bank transfer in euros
  •  Visa
  •  MasterCard

Payment by Check

If you pay by check or money order, make it payable to Midwifery Today. Payment may be made in sterling, euros or U.S. funds.

Payment by Credit Card

All credit cards will be charged in U.S. dollars at the listed U.S. prices. We cannot make any guarantee of exchange rate. All fees for fund conversion are the responsibility of the payer.

Payment by Bank Transfer (using the sterling prices)

Midwifery Today, Inc., account at:

HSBC Bank plc, 60 Queen Victoria St, London, EC4N 4TR, UK
Account number: 01742957
Sort code: 40-05-30

Important: Include registrant name(s) with funds transfer.

Note: The sender is responsible to pay any bank fee charged for the transfer.

Payment by Bank Transfer in Euros

Please e-mail admin@midwiferytoday.com for details.

Refund and Cancellation Policy

Refunds: No refunds of conference registration fees will be given after 15 April 2014. A processing fee equal to 30% of the amount paid will be deducted from any refund given on or before this date.

Rooming refunds: No refunds of rooming fees will be given after 19 May 2014. A processing fee equal to 10% of the amount paid will be deducted from any refund given on or before this date.

Form for Credit Card Payment

Please complete the following items if you are paying by Visa or MasterCard.

Amount to be charged to your credit card in U.S. dollars 
Account number (Visa/Mastercard)*
*Must be 16-digit number starting with a “4” or “5”
 
Expiration date  [ month / year ] 
Name as it appears on the credit card  [ please print ] 
Billing address if different from above  [ please print ]
 
 
 
Billing phone and/or e-mail address  [ please print ] 
Signature 

6. Information

How to Submit Registration and Payment

  1. For online registration: Go to midwiferytoday.com/conferences/UK2014/. For registration by mail or fax: Please read and complete all of this form. Then make a photocopy for your records.

  2. You may mail this form with your payment in sterling, euros or U.S. funds to Midwifery Today. If you pay by credit card or bank transfer, you may fax this form to Midwifery Today. You may also register by phone or e-mail. (Do not send credit card details by e-mail.) Use the addresses and telephone numbers at the bottom of this form.

  3. Registration by post, phone, fax or e-mail must be received in office at Midwifery Today no later than 12 May 2014. If you cannot submit your registration and payment early enough for it to be received by 12 May 2014, please register online or at the conference. There is no deadline if you register through the online system and pay by Visa or MasterCard in U.S. dollars.

Location of Conference/Hotels

Please see information on location and accommodations on our Bury St. Edmunds, UK, conference gateway page.

Continuing Education

A certificate of attendance will be provided to each participant. No U.S. CEUs will be provided.

Contact Addresses and Telephone Numbers

Midwifery Today
P.O. Box 2672
Eugene, OR 97402-0223
U.S.A.

conference@midwiferytoday.com
1-800-743-0974  [ U.S. and Canada only ]
+1 541-344-7438
+1 541-344-1422  [ fax ]

Conference Updates

Program changes: Speakers, classes or other details may change; please visit:

www.midwiferytoday.com/conferences/UK2014/updates.asp

Disclaimer

Midwifery Today, Inc., cannot be held responsible for natural disasters, labor strikes, acts of war or other events that may cause the conference to be rescheduled. Midwifery Today, Inc., reserves the right to postpone the conference to another time, date and if necessary, location. In the event of a conference postponement no refunds will be issued. Registrants can transfer their fees toward any other Midwifery Today conference.

Midwifery Today, Inc., reserves the right to substitute teachers and/or classes. The views and opinions expressed by teachers are their own and may not represent the views and opinions held by Midwifery Today, Inc., and its staff members.