EmailMe Form - Subscription Form Vlerick Alumni Golf 2015

PERSONAL INFORMATION (VLERICK ALUMNUS)

Name *

First Name *

Student

Programme *

Graduation Year *

Street and Street Number *

Postal Code *

City *

Country *

Telephone *

Email *

REGISTRATION FORMULAS

Please select the proper option

I want to subcribe for *

Free Brunch (between 10:00 and 12:30) *

Indicate the right number of participants

I want to enroll a guest for *

I (also) want to register for the Dinner at 19:30 (Wine & water included) *

GOLF HANDICAP

Mandatory for Golf Challenge participants

My exact Playing Handicap (max 45)

My Federal Number

My Home Club

GUEST INFORMATION

Name Guest

Guest is Vlerick alumnus

If possible, I'd like to play with my guest

(*) Will not be possible if you and your guest's handicap will not allow you to play on the same course

Guest's Exact Playing Handicap (max 45)

Guest's Federal Number

Guest's Home Club

PAYMENT DETAILS

Total amount to be paid *

I will transfer the registration fee(s) to: IBAN: BE77 7310 2236 5242 - BIC: KREDDEBB before 2 June 2015 *

Yes (1)

(1) Subscriptions for which payment is not received by 5 June 2015 will be canceled and freed up for the waiting list.

Due to a recurring massive interest for the Golf Initiation, we strongly advise an early payment for this activity.

Cancellations received after 9 June 2015 will not be refunded.

Comment on payment: Please clearly indicate: Vlerick Alumni Golf Challenge - your name (in case of a company payment) and subscription reference (Rxxx number).

Personal Comment/free text

* Mandatory Fields

Waiver

When registering for the golf event, I declare that I waive the rights to the pictures which have been taken for the purpose of Vlerick Business School and Vlerick Alumni.

I also grant the school the permission to use my pictures and any other reproductions or adaptations for all offline communication (programme brochures, posters, etc.) and online communication (website, online banners, etc.) produced and used by Vlerick Business School and Vlerick Alumni.

The school guarantees that my pictures will not be used in an abusive way.