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Registration Form
First Name:
Last Name:
Designation:
Organisation:
Contact Number:
Email ID:
Billing Entity Name:
GSTIN (if applicable):
Billing / GST Address:
Pin Code:
Country:
I have read and agree to the
Terms and Conditions
Delegate Fee (domestic) - INR 10,000 + GST
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*Payment gateway transaction charges extra
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Add-on Options
Hotel Accommodation
1N with breakfast - INR 12,000 + GST
2N with breakfast - INR 24,000 + GST
Check-in Date:
Check-out Date:
Govt ID Proof:
Travel Arrangement
Pick-up From:
-- Select --
Goa International Airport
Manohar International Airport
Pick-up Date:
Pick-up Time:
Pick-up Air Ticket Ref:
Govt ID Proof (Pick-up):
Drop To:
-- Select --
Goa International Airport
Manohar International Airport
Drop Date:
Drop Time:
Drop Air Ticket Ref:
Govt ID Proof (Drop):
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