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REGISTRATION FORM Personal Details Title First Name Surname Name Appearing On Badge Gender:

Birth date

M

F

Address City

Post Code

Country Fax

Telephone E-Mail* Facebook Meal requirements

Vegetarian

Website Allergies:

Please notify INWA by September 1, 2012 if you need any special requirement as a result of disability. I have read the ReleaseForm on page 3 Languange: English Yes No

Italian Yes No

Other:

* Required- All Meeting Information Will Be Sent Via Email

Nordic Walking Information What is your Nordic Walking National

_____________________________________

Association? Is This Your First INWA Convention?

_____________________________________

Category? Leader

Instructor

What is your Nordic Walking poles size?

Coach 105

International Coach 110

115

Other 120

125

130

Payment Details Education Fee

Registration Conference (27/09-30/09) Registration Update Course (27/09)

Early

Regular

Registration

Registration

until 27 July

Until 12 September

2012 €270.00 €67.00

www.inwa-nordicwalking.com - office@inwa-nordicwalking.com Jollaksentie 27 A - FIN-00850Helsinki - Finland

2012 €300.00 €75.00 2


Registration Conference and Requalification One Day Registration Conference 27/09 28/09 29/09

Book both and get Requalification

Registration One Day Conference and Requalification

€317.00

€375.00

€300.00 €99.00

€337.00 €110.00

€166.00

€185.00

TOTAL

How to Book - Payment Method 1. 2. 3. 4. 5.

Complete the Registration F orm Read the Release Form Bank Transfer to INWA Take a copy for your record Send the registration form with the bank receipt to office@inwanordicwalking.com or fax this form to 00 44 2084454520 to reserve your place

INWA Bank Account Information Nordea Bank Plc 1572 Helsinki – Senaatintori Account no: 157230– 366 260 SWIFT: NDEAFIHH International Bank Account number (IBAN) FI22 1572 3000 3662 60

Other Information Release Form The INWA Conference contains practical sessions designed for fit and healthy people. Participants with any physical restriction, disability or predisposition to injury or sickness should not participate if their health or ability to exercise is at risk. Signing this document confirms acknowledgement of the following: 1. That willing participation in the event is at your own risk. www.inwa-nordicwalking.com - office@inwa-nordicwalking.com Jollaksentie 27 A - FIN-00850Helsinki - Finland

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2. That you have no physical restriction, disability or any other predisposition to sickness or injury that may be adversely aggravated or affected as a result of participation in any of the sessions.

3. That full responsibility by you, the participant, is acknowledged for any injury, loss or damage to your person or property that may arise directly or indirectly from participation in the event.

4. That as a participant you will not seek compensation from, nor penalise or prosecute the organisers, sponsors, presenters or other participants of the event for any injury, loss or damage to your person or property. Registration Information Early registration ends May 27, 2012 and the normal Registration ends September 12, 2012 INWA reserve the right to cancel this event without penalty. Attendees who purchase non-refundable airline tickets, do so at their own risk. The total amount of any liability of the planners will be limited to a refund of the registration fee. Your submission of this form acknowledgesacceptance of these terms. Cancellation Policy Cancellations will be accepted if sent in writing to the INWA Office and postmarked or e-mailed to office@inwanordicwalking.com by August 27, 2012. A service charge of â‚Ź50 will be applied to all cancellations. Refunds will not be issued for cancellations made after August 27, 2012. Image/Likeness /Voice Release: I understand and agree that INWA Conference Organisers may film, photograph and/or record me during the event and that INWA retains the right to use any such film, photograph and/or recording for any future publishing or promotional purposes. As a participant of the event, you have carefully read and understood all the above and understand that participation in the event will only be permitted by agreeing to all the above. Your submission of this form acknowledgesacceptance of these terms.

Signature: _____________________________________________________Date:_____________

www.inwa-nordicwalking.com - office@inwa-nordicwalking.com Jollaksentie 27 A - FIN-00850Helsinki - Finland

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2012 Convention Registration Form