REGISTRATION FORM

First name

Date of birth

Sex
 M F

Home address

City

Nationality

Profession or type of studies

Category

Phone/Mobile

Emergency contact (name)

Languages spoken

Communications and/or observations

Particular skills useful to the camp
(social entertainment, repair and fixing of secondhand material, cooking, etc.)

Last name

Place of birth

Nationality

Postal code

Province

Tax ID code

Driver's license
 Yes No

Willing to drive camp vehicles
 Yes No

E-mail address

Emergency contact (E-mail and phone)

Special dietary requirements

Session chosen
1st session - 5/12 july2nd session - 12/19 july3rd session - 19/26 july4th session - 26 july/2 august6th session - 9/16 august7th session - 16/23 august8th session - 23/ 30 august

After having carefully read the conditions for participation I accept and undertake to respect the conditions for participation in the INTERNATIONAL VOLUNTEERS CAMP OF PALERMO 2015. I also declare that I am in good psychophysical condition, compatible with my participation in the camp
Before registering the managers and members of Emmaus have to read here and specify in the communications and observations the community of origin, its e-mail, telephone and reference manager

Note about privacy

We inform you that, pursuant to art. 13 of L.D. no. 196 dated 30 June 2003, (containing the "Code on the protection of personal data" hereinafter referred to as the "Privacy Code"), the personal data supplied in connection with the initiative EMMAUS INTERNATIONAL VOLUNTEERS CAMP OF PALERMO 2015 will be collected and recorded by EMMAUS ITALIA in respect of the provisions of the Privacy Code. We inform you that the data supplied will be used exclusively for purposes strictly connected with and instrumental to the initiative and/or if necessary to contact you for similar initiatives promoted by EMMAUS ITALIA. In this connection, your data, with the exception of your e-mail, may be published online in the list of persons who have registered for the initiative. The supply of your data is necessary in order to participate in the initiative. The indication of your e-mail will enable you to receive information about possible similar activities or initiatives promoted by EMMAUS ITALIA. We inform you that you may exercise the rights envisaged by art. 7 and thereafter of L.D. no. 196/2003 (including, by way of example, the right to obtain confirmation of the existence of data concerning you and its communication in intelligible form, information about the mode of use, updates, correction or completion of the data and its deletion) by contacting the data user without any particular formality at the address of the registered office or by writing to the following specific e-mail address: info@emmaus.it. The data user is EMMAUS ITALIA onlus (non-profit association), with registered office at via di Castelnuovo, 21/b – 59100 PRATO – ITALY. Pursuant to articles 13 and 23 of the Privacy Code, having read the information, I consent to the subsequent use of my personal data (including my e-mail address) by EMMAUS ITALIA onlus (non-profit association), to be informed about initiatives. In case of non-consent, the data will be used solely in connection with this specific initiative.
I accept  Yes No

AUTHORIZATION OF PHOTOGRAPHS AND VIDEO FILMS

In the context of the activities that will take place during the EMMAUS IINTERNATIONAL VOLUNTEERS CAMP OF PALERMO 2015, photographs and/or videos may be made, not for purposes of sale but purely for educational-didactic purposes (signs, cards, Powerpoint presentations, the EMMAUS ITALIA website), or for promotional purposes.
For this purpose, pursuant to the law on privacy no. 196 of 2003, the participant (or parent, in case of a minor) authorizes the use of photos and/or videos.

For this purpose, pursuant to the law on privacy no. 196 of 2003, the participant (or parent, in case of a minor) authorizes the use of photos and/or videos.
I accept  Yes No

(*) NOTE: the contribution for participation is understood as an offer for the Emmaus initiatives and as an agreement to participate. This contribution cannot be refunded. Failure to pay the contribution will automatically cancel the registration.