BSLMS Workshop Registration

Personal & Professional Details

Full Name *

Gender *

Age *

Mobile Number *

Email ID *

City & State *

Postal Address *

Professional Background

Designation *

Years of Experience *

Upload your MD / DNB DVD/ certificate / PG Students to upload college ID proof *

Institution / Clinic Name *

Specialty / Practice Focus *

GST No

GST Name

Skills & Workshop Preferences

Laser Experience Level *

Attended 3D Training Before? *

Expectations from the Workshop *

Interested Laser Systems / Procedures *

Preferred Workshop Location *

Workshop Date *

Registration & Declaration

Amount (Including GST) *

I hereby declare that:

The information provided by me in the registration form is accurate and complete.
I understand and accept the terms and conditions of participation in the BSLMS 3D Workshop.
I agree to abide by the workshop rules and conduct myself in a professional manner throughout the event.
I release the organisers, faculty, and associated parties from any liability for loss, injury, or damage incurred during my participation in the workshop.

I accept the above terms & declare my consent to participate.