Registration Belgian Buckler Symposium 16.12.2023 by Ex Cineribus Grimbergen

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Thank you for your registration. This registration form is for intern use only, such as insurance et cet.

Your registration will be finalized after the payment of the fee of 30 euros on the following bankaccount

Be73 7340 3812 6160

note: BBS 2023 <last Name> , < Firstname>

Email *

Last name *

First name *

Club (if applicable) *

E-mail *

Telephone number *

date of birth *

YYYY

Emergency contact *

Without going in to details, are there medical issues that have to be considered of mentioning? *

Are we permitted to take and use pictures of you on this event and use them on social media? *

Yes

Yes, but only with fencingmask on so I am unrecognizable

I understand my registration is only finalized after the payment of the fee of 30 euro on the following bankaccount

Be73 7340 3812 6160

note: BBS 2023 <last Name> , < Firstname>

Yes

I untherstand that all this information is only used for the practical organisation of the event such as contact (email, telephone) insurance (name), and will not be used toughtless or distributed in any way. *

Yes

Opmerkingen

A copy of your responses will be emailed to the address you provided.

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