Registration form Extreme Extremities
Thank you for your interest in the Extreme Extremities Symposium on Saturday June 24th! Please fill out this form to register for the symposium.

The symposium will take place at Rijksmuseum Boerhaave. The doors are open at 09:30 and the speakers will start at 10:00. The symposium will last until 16:00. 

A ticket costs €5,-, the registration for lunch is closed, but you can still register for the symposium. You do need to bring your own lunch then.

Do not forget to bring your student card or museum card for free entrance to the museum!
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First name: *
Surname: *

Phone number:
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E-mail adress: *
Do you have a LBC-membership? *
I agree to the privacy statement of the Leidse Biologen Club
https://leidsebiologenclub.nl/wp-content/uploads/2020/05/Privacyverklaring.pdf
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I understand that I can cancel my registration until June 23th 14:00 without any costs.  *
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I understand that I need to bring my own museum ticket (student card/ LU card, museumjaarkaart etc.) if I have one.  *
Required
I understand that I need to deposit €5,- to NL69 INGB 0008 3821 97 (t.n.v. Leidse Biologen Club) with "Extreme Extremities Symposium [your name]" in the discription, before June 23th 16:00. 
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