Equitherapie - Registration Meeting and Hotel

Leonardo Da Vinci Project

A European qualification framework for practice and training in Animal Mediated Assistance and Therapy (AMAT)

4th Meeting of Partner Organizations 7th - 9th october 2011

organized by

SHP Nederlandse Stichting Helpen met Paarden - Equitherapie

in cooperation with the trainings centre HippoCampus Cranendonk The Netherlands

With this form you can register for the Meeting at SHP and for the hotel reservation directly with

Golden Tulip Hotel Jagershorst
Valkenswaardseweg 44, 5595XB Leende
0031 88-1188820
info@goldentulipjagershorst.nl

This form is for foreign participants only. The Members of the Dutch Team will plan their presence at the following Skype conference following week

Before sending you can print the form using the print link at the end of the page below left

You receive a confirmation per mail

Name:*
Address:*
Postal Code:*
City:*
Country:*
Phone:*
E-mail:*
LDV Partner Organization :*
Meeting Registration:*
I want to participate :
SHP program on AMAT on Friday 7th:
Dinner on Friday 7th:
Dinner on Saturday 8th:
At the 4th meeting:*
Namely:
Iinformal " come together" on Thursday 6th evening:
For Hotel Registration :*
Hotel Registration: With this registration I am making an appointment with the Golden Tulip Hotel "Jagershorst " directly
Credit Card Number, Company, Expiration date and CVS code:
Registration appointment: My registration can be cancelled untill 24 hours before booking date with Hotel Golden Tulip directly.. In case of later cancelling the room has to be payed .
I agree to the registration appointment :
Room registration:*
Together with:
For the time of:*
Namely:
If I want to change the arrangement: I contact the Colden Tulip Hotel Golden Tulip Jagershorst directly.
Notes:
A * behind a field, means that this field is required!