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the Accommodation Form - WORLD LEISURE CONGRESS 2012

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					                              XII WORLD LEISURE CONGRESS
                       September 30 – October 3, 2012 – Rimini (Italy)

                                        ACCOMMODATION FORM
               Please, fill in and send to Firma Eventi di Egocentro Srl by fax (+39 (0) 541 760388 or
                     by e-mail (info@riminiworldleisure.com) no later than August 30, 2012


□ Mr. □ Mrs. □ Dr.     □ Prof.

First Name _________________________ Family Name ____________________________________

Affiliation __________________________________________________________________________

Department ________________________________________________________________________

Function ___________________________________________________________________________

Address ___________________________________________________________________________

ZIP Code ______________ City _________________________________ Country ________________

Fax _____________________ E-mail ____________________________________________________

Phone _______________________________ Mobile phone ____________________________________



                            INFORMATION REQUIRED FOR INVOICING
Heading ___________________________________________________________________________

Address ___________________________________________________________________________

ZIP Code ______________ City _________________________________ Country ________________

VAT number ____________________________ Fiscal Code ____________________________________

ONLY FOR PARTICIPANTS NOT LIVING IN ITALY:

Birthday ________________ Birth place and country __________________________________________



                                                HOTEL RATES
                                            double room single use                          double room

CATEGORY A                                          € 150,00                                  € 180,00

CATEGORY B                                          € 100,00                                  € 120,00

CATEGORY C                                          € 70,00                                   € 90,00

CATEGORY D                                          € 45,00                                   € 70,00

CATEGORY E                                          € 30,00                                   € 50,00
Above rates are per room/per night, breakfast and VAT included.


                                                                                                          PAGE 1/2
                                 XII WORLD LEISURE CONGRESS
                          September 30 – October 3, 2012 – Rimini (Italy)


                                         REQUEST FOR RESERVATION
I herewith request the reservation of:
□ N. _______ double room single use
□ N. _______ double room               □ double room (one bed)
                                       □ twin room      to be shared with ___________________________

Arrival date ________________ Departure date _____________________ N. of nights ______________

Hotel Category ______________________________________________________________________

Following your request Firma Eventi di Egocentro will send you the proposal of accommodation.
In the event hotels in the requested category are fully booked upon receipt of the Accommodation Form, Firma Eventi reserves
the right to offer accommodation as close as possible to the request.
As a final confirmation of the hotel booking the payment of the whole stay will be requested.


                                                        PAYMENT
The payment for the whole stay can be made as follow:

□ Bank transfer to:
       EGOCENTRO Srl – Banca Popolare Emilia Romagna – Filiale N. 7 di Rimini
       IBAN Code: IT55F0538724206000000851390 – SWIFT Code: BPMOIT22
       Re.: XII World Leisure Congress + participant name
       All bank remittance charges must be prepaid. Please, be careful not to deduct them from the deposit.
        Please, enclose copy of your bank transfer.

□ Credit card: □ VISA             □ MASTERCARD

        Credit card number _________________________ Holder ________________________________

        Birthday _________________________________ Expiry date_____________________________

        Date ___________________ Holder signature _________________________________________
        Please, enclose copy front and rear of your credit card and identity document.


                                        CANCELLATIONS AND REFUND
Cancellation must be made in writing to Firma Eventi di Egocentro. In case of cancellation:
    • before August 30, 2012: full reimbursement of the amount paid will be made
    • from August 31, 2012: a deposit of 1 night will be kept in case of a stay up to 3 nights while a deposit of 2
        nights will be kept in case of stay of 4 nights and more.
For administrative reasons all refunds (net bank expenses) will be processed after the Congress.


PROTECTION OF PERSONAL DATA
D.L.G.S. June 30, 2003, n. 196 code of protection of personal data under the Italian Law 675/96 (Privacy).

According to the Italian Law above indicated concerning the collection and processing of my personal data, I herewith
□ AUTHORIZE □ DO NOT AUTHORIZE
sending to my address of periodic information, offers, newsletters and brochures or cards also through other subjects.
□ AUTHORIZE □ DO NOT AUTHORIZE
communication to other people about my participation in the event, for the sole purpose of receiving and transmitting
correspondence, phone calls and messages addressed to me.


Date __________________                                      Signature ____________________________________


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