The 33rd Japanese-Korean Combined Orthopaedic Symposium

Registration
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Please fill out the folowings. * is required field.
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Pleaes answer all the *mark field; othrwise, it becomes an error and you cannot go on next page.
Reistrant Information
Name*
Given Name (First Name)
Family Name (Last Name)
Title*
Organization*
Home or Office Address*
Address (Building Name, etc.)
Street*
City*
Zip Code*
Country/Region*
TEL*
FAX
Mobile*
Email*    （Confirmation）
Registration / Payment Information
Registration Fee*
JPY20,000
JPY10,000
JPY0
JPY0
Special Code Special Code is correct Special Code is incorrect.
Dietary Requirements*
Banquet*
JPY10,000
JPY0
Accompanying Person
(Family Member)		 It is JPY5,000 per person
Banquet Additional Ticket It is JPY10,000 per person
Excursion Tours* 1-day Tour (September 27th, 2025)
It is JPY26,400 (tax inclusive) per person
Mini Tour (September 28th, 2025)
It is JPY24,200 (tax inclusive) per person
Golf Outing (September 28th, 2025)
It is JPY16,500 (tax inclusive) per person
Payment Method
Payment Amount
Payment Method Credit Card
Credit Card*
Credit card no.*  
※Don’t include hyphens. If using Amex, add ‘0’ before the number to make it 16 digit.
ex. Amex 3123-456789-12345, becomes 0312345678912345.
Name on the credit card*
Expiration date* (Month)／ (Year)
Security code*
* A 3- or 4-digit number printed on the back or front of your credit card
Receipt addressed to