FORMULAR INSCRIRE - REGISTRATION FORM
ROATA MEDICINEI SI UNELTELE SAMANULUI (RM-US)- Chris Waters - Modulul SUD /  MEDICINE WHEEL & PRACTITIONER TRAINING - SOUTH Module
Perioada de desfasurare / Period: 10-15 Mar 2023
- Valentin Neata – vali_neata@yahoo.com; tel. +40 722 600 234; 
- Simona Lederman - ledermansimona@gmail.com; tel. +40  758 691 051
Locatie / Location : Hotel Floris,  Drum Național 1A, Nr. 17, cod 107356, Cheia, Prahova

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Nume / Last name *
Prenume / First name *
Adresa de resedinta (cel putin orasul si judetul) / Address (at least town and country)
E-mail *
Telefon / Phone number *
Ai mai urmat cursul Roata Medicinei cu Chris Waters sau Team-ul scolii? *
Te rugam sa platesti un avans de 600 RON (nereturnabil) , in contul RO65 BTRL RONC RT05 0263 9101 deschis la Banca Transilvania, beneficiar SC INTI RISE SRL; CUI: 41220470 - pentru rezervarea unui loc la curs. Te rugam sa mentionezi in detaliile de plata "curs Roata Medicinei SUD" si numele participantului. / Please pay 600 RON deposit (non-refundable) , in the account RO65 BTRL RONC RT05 0263 9101 opened at Banca Transilvania, beneficiary SC INTI RISE SRL; CUI: 41220470 - for booking a place for the training. Please mention in the payment details "Medicine Wheel South" and the name of the participant. *
Voi plati restul pana la valoare cursului pana cel tarziu 04 martie 2023   / I will pay the remaining amount until 04 March 2023 *
Data sosirii / Arrival date *
Daca sosesti de Joi 09 Martie, dupa amiaza - Doresti masa de seara ? /  If you arrive on Thursday, March 9, in the afternoon - Do you want dinner? *
Optiune cazare - pret cu TVA inclus si mic dejun inclus  (detalii camere pe site hotel) / Accommodation option - price with VAT and breakfast included  ( room details on venue internet site)  https://hotelfloris.ro/

 *
Cu cine doresti sa imparti camera? (raspuns optional) / Who do you want to share the room with? (optional answer)
Optiune mese* (micul dejun este deja inclus in pretul camerei) / Meals option* (breakfast is already included in the room rate) (*) Pranzul si cina tip bufet / Lunch and dinner is buffet type *
Optiune meniu / Menu option *
Date de facturare (raspuns optional), doar daca doriti factura pentru serviciile de la hotel: cazare si masa (firma/persoana fizica, CUI/CNP; Nr. reg. com.; adresa, oras) / Invoicing data (optional answer), only if you want invoice for hotel services: accommodation and meals (company name/ individual, registered number, address, town;)
Alte observatii - daca sunt, inclusiv observatii legate de anumite restrictii alimentare (raspuns optional) / Other remarks - if any, including remarks on certain food restrictions (optional)
Acord prelucrare date personale / Personal data processing ageement *
Required
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