Full name*

E-mail*

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Medical specialization area*

Medical license number*

I hereby consent to my personal data being processed by POZNAN LAB and by MERZ for the purpose of registration to the webinar.*

I am physician and have the right to practice medical profession in my country of residence.*

I undertake not to record copy or share material presented during the webinar to third persons.*

I consent to the processing of personal data provided in order to participate in the webinar in accordance with the Act of May 10, 2018 Personal Data Protection (Journal of Laws 2018, item. Parliament and Council of April 27, 2016. On the protection of personal data of April 27, 2016. On the protection of personal data with the contamination of personal data and the protection of personal data, such as data, and repealing Directive 95/46 / EC (General Data Protection Regulation).*

I have read and understood the Merz General Data Protection Information (https://www.merz.com/app/uploads/2019/06/Fair-Information-Notice_Merz.pdf)*

I am aware that VIMEO LLC is used as a platform and therefore the data protection provisions of VIMEO LLC apply.*

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