Survival Weekend 19 registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

By filling in this form you register to Survival Weekend 19 (SW19),
which takes place 7th - 9th April 2017

Deadline for registrations is 31st of March.
The participation fee is 1590CZK.

Please note:
Your registration is binding, cancelation fees apply (see buddyhk.cz for more information).
The data you share with us are confidential and for SW19 purposes only and it won't be accessible for third parties.
If you have any questions, feel free to ask us at sw@buddyhk.cz
Accommodation is in chalets for 4 or 5 people.

Name *

Surname *

Nickname *

Sex *

Female

Male

Nationality *

Date of birth *

DD.MM.YYYY

Your Erasmus University *

Choose your University in Czech

E-mail *

Czech phone number *

Digits only, for instance: 00420 605 123 456

I do NOT eat pork.

I do NOT eat meat at all.

Allergies and medical restrictions

For example important allergies to food, medicines, etc.

With whom do you want to be accommodated in the cottage during SW19?

Write the full names of your friends please. If you don't care with whom you will be accommodated, don't fill this paragraph. (you still may not be accommodated with who you wish due to capacity reasons, but we will try our best)

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of ESN Hradec Králové. Report Abuse

Forms