Registration Form

7th Children Focusing Conference 2010
“Sparkling Energy”

Before you register you need to know:
  1. Payment should be made in Euros.
  2. The fee covers all the cost of organization, lunches, coffee breaks, dinner, and bed and breakfast as well.
  3. On registration, 150 euros must be paid, which is non-returnable on cancellation.
  4. The rest of the amount is to be paid by the 1st of September.
  5. We have only 2 double rooms in our conference center and only 1 room for three persons.
  6. Registration is on a first come, first served principle.

Title: Mr. Mrs. Ms. Miss
Christian name
Surname
Address
Postal/Zip Code
City
Country
Phone
Mobile
E-mail
 

Special food requests:
Vegetarian
Other dietary concerns:
Remarks:
 
Note: all indoor spaces are non-smoking.
 

Please register me for:
(please check your choice in the list below)
4 nights p.P. (€ 480,--) shared rooms 6 persons
4 nights p.P. (€ 510,--) shared rooms 4 persons
4 nights p.P. (€ 580,--) shared rooms 3 persons
4 nights p.P. (€ 650,--) double room 2 persons
Dayguest (€ 45,--) on Friday

Payment:
Amount paid now full amount
€ 150,-- deposit (non-refundable)
 
Roommates:
please find me roommates
please put me with (names)
 
Payment Method:
 
Account holder: Stichting Kinderfocussen
Account number: 5027136
Bank name: ING
Bank address: The Hague, The Netherlands
Reason for payment: Conference 2010
   
For international transfers:  
SWIFT-BIC: NL65INGB0005027136
IBAN: INGBNL2A
 
I am applying for a scholarship
 
Date:
 

Any other questions about registration or your stay during the conference: mail .