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International Watsu Conference, Krakow 2015

* 1. Name and surname
* 2. Street address
* 3. Address
City, ZIP code, country
* 4. Phone
starting from area code +.....
* 5. E-mail
* 6. I want to take part in the conference as:
Lecturer (Early Bird price 130 Euro till 15th August and 170 Euro later)
Participant (Early Bird price 115 Euro till 15th August and 155 Euro later)
Student (Early Bird price 55 Euro till 15th August and 80 Euro later)
Accompannying person (Early Bird price 45 Euro till 15th August and 55 Euro later)
* 7. I want to take part in
Lectures
Practical Workshops
Banquet
8. I register as a student and I want to take part in a banquet for additional fee (Early Bird price 20 Euro till 15th August and 25 Euro later)
Yes
No
9. I am
All eating
Vegetarian
Vegan
Other (please specify in the box Message to Organizer later)
10. Please help me with
Transportation from/to the airport
Finding a hotel
Arranging the visa
Other
* 11. I want my invoice for
Private person
A company
12. If company, provide data
Name of the company, adress, tax number
* 13. I am interested in hydrotherapy events, trainings etc of Watsu Polska and I want to receive a post-conference materials and a newsletter after the conference
Yes
No
* 14. I wear T-shirt size of
(for conference T-shirt)
XS
S
M
L
XL
XXL
15. Message to the Organizer
* 16. Name and surname (Signature)
I state I know and accept terms and conditions of participation in 3rd International Watsu Conference, 2nd - 4th October in Krakow, Poland available on www.watsu.org.pl
* 17. Date


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