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Surname * |
Name * |
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Address * |
ZIP Code * |
City * |
Country * |
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Birth place * |
Birth date * |
Home phone |
Email * |
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Mobile number |
Frequent School Name |
Hear From |
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how did you know about the MB International Summer Camp
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PARENT 1: Surname and Name: * |
Mobile phone * |
Email * |
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PARENT 2: Surname and Name |
Mobile phone |
Email |
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COURSE INFO: |
Program Selected * |
Preferred Language * |
Language Level * |
Sports * |
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Weeks |
From |
to |
I wish to stay with |
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TRAVEL DATA: |
Arrival at * |
Departure from * |
Travel Notes |
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PERSONAL INFORMATION: |
Does the student suffer from particular illnesses, allergies or food problems or take medication regularly? |
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Favorite Hobbies & Sports |
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MB Enrollment Fee |
110,00 € |
Package Price |
0,00 €
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Transfer from airport / station on arrival * |
Yes
No
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0,00
€
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Transfer From airport / station on departure * |
Yes No
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0,00
€
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Cancellation insurance (6% of total) * |
Yes
No
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Additional medical insurance (45€) * |
Yes
No
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NB: THE FINAL PRICE, AT THE TIME OF THE BALANCE, CAN BE SUBJECT TO VARIATIONS DUE TO CHANGES IN CURRENCY |
Deposit amount |
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AUTHORIZATION OF PARENTS FOR STUDENTS OF 18 YEARS |
I declare to have read and approved the information and the general conditions provided by MB * |
Yes
No
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I authorize my child to leave the village without supervision (only 16+) * |
Yes No
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I authorize the school to provide immediate medical assistance * |
Yes No
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I pay the deposit and send a copy of payment by email by * |
Credit Card or Paypal |
Bank transfer to: BANCA MONTE DEI PASCHI DI SIENA SPA (IBAN: IT59T0103012190000003141010 BIC: PASCITMMXXX) |
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I confirm to have read and abide to the rules and the information provided by the data protection law D.Lgs. 101 del 10/08/2018 * |
GIVE YOUR CONSENT TO THE PROCESSING OF PERSONAL AND / OR SENSITIVE DATA NECESSARY FOR THE PERFORMANCE OF THE TRANSACTIONS INDICATED IN THE ABOVE, INCLUDED THE PROMOTIONAL AND ADVERTISING |
PROVIDE YOUR CONSENT TO THE PROCESSING OF PERSONAL AND / OR SENSITIVE DATA NECESSARY FOR THE PERFORMANCE OF THE TRANSACTIONS INDICATED IN THE ABOVE, EXCLUSION OF THE PROMOTIONAL AND ADVERTISING |
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