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I hereby register for the 4th International 2CV-Meeting in Germany
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| first name: |
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| last name: |
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| street,number: |
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| postal code, city: |
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| date of birth: |
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sex |
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e-mail: |
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| nationality: |
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| phone: |
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| vehicle: |
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| license plate number: |
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| Year of manufacture: |
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| distance from home(km): |
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| total number of persons: |
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| thereof number of children 14 years and younger: |
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| number of children 15 years and older: |
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| fee: |
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I read and accepted thesite rules
of the Organiser.
The meeting fees are not refundable, the ticket is however transferable.
By giving my e-mail address I accept this e-mailed form as an official registration.
I transfer my registration fee to the following German bank account of the organisers (from outside Germany, only transfers using BIC and IBAN numbers are accepted):
"DET 2010 ORGA-Team"
Inge Braune & Michael Schneider - Braune
acount number: 71879005, bank:VoBa - Tauber, BLZ 62391420,
IBAN:DE316239142000071879005, SWIFT/BC:GENODES1VVT
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or
I pay my registration fee by means of a debit entry. In this case, the following information is needed additionally:
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| address of the account owner |
| name: |
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| street: |
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| postal code, city: |
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I hereby autorise you revocably to draw the applicable registration fee once by means of a debit entry from my account:
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| account number (IBAN): |
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| bank identification code (SWIFT/BC): |
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| complete name of the bank: |
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debit entry from my account:
If my account does not have sufficient coverage, my bank is not obligated to redemption. Redemptions of parts of the total sum will not be accepted.
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I af´gree that my personal data given in this form will be stored electronically:
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| Yes (if you do not agree you cannot register online) |
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