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participation form
Training Course ""Healthy lifestyle to combat stereotypes""
09/12/2022 - 09/20/2022
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First Name (as in your PASSPORT)
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*
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Last Name (as in your PASSPORT)
birthday
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ID Number
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country of residence
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Emergency contact (name, relationship, phone number with country code)
When do you plan to arrive at Paola TRAIN STATION?
When do you plan to depart from Paola?
What time do you plan to arrive to Paola TRAIN STATION??
What time do you plan to departure from Paola?
Please specify if you have any special needs (vegetarian, vegan, health issue etc.)
Have you been vaccinated against COVID-19?
*
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No
With which vaccine are you vaccinated?
Have you recovered from COVID-19?
*
Yes
No
Do you have EU Digital COVID Certificate?
*
Yes
No
How many shots of vaccine have you received?
Select your sending organisation
*
Romania - ATIC
Spain - Asociación PROJUVEN
Czech Republic - Czech Youth Association
Italy - Associazione Progetto Europa
Slovakia - Youth for Equality
Germany - Copernicus Berlin e.V.
Please add any additional comments if any
I hereby confirm that I am a resident of the country I represent
I agree that during this training course pictures and/or videos of the participants will be taken and published on the homepage (https://www.copernicusberlin.de/), in (print) publications, on the Facebook, Twitter, Instagram, Youtube, LinkedIn pages of COPERNICUS BERLIN and may be saved for this purpose*
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participant declaration*
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