Registration Form for participants in presence

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Email *

Name *

Surname *

Institution *

Country *

Role in Rest-Coast *

WP Leader

Task Leader

Participant to the project

Competent Authority

Other

Required

I will participate to the boat field trip in Venice lagoon on Tuesday 18th October. *

Yes, I will

No, I will not

Field trip: number of accompanying persons (if any)

Days of attendance to the meeting *

Wednesday 19th October

Thursday 20th October

Friday 21th October (half day)

only ON-LINE

Required

I will participate to dinner on Wednesday 19th October at my expense (40 €) *

Yes, I will

No, I will not

Dinner: number of accompanying persons (if any)

Please indicate any particular dietary need (vegetarian, fish allergy, etc)

Day of arrival

Your hotel

Authorizations *

I am aware that my data will be stored in compliance with the provisions of the Regulation (EU) 2016/679

I AUTHORIZE CORILA to acquire the video and/or photographic images of the undersigned on the occasion of the meeting and to exhibit and/or publish, in whole or in part, such video and/or photographic images for internal and external communication purposes. I also declare that I renounce any right and / or consideration and / or claim of any nature whatsoever deriving from the use of said video and / or photographic images and that I have nothing to claim from CORILA for any present or future title for the use of the above.

Required

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