Registration

Title *

MrMrsMs

Surname *

First name *

Email address *

Nationality *

—Please choose an option—AustriaBelgiumBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGermanyGreeceHungaryIrelandItalyLatviaLithuaniaLuxembourgMaltaNetherlandsPolandPortugalRomaniaSlovakiaSloveniaSpainSwedenUnited KingdomOther

Association *

OfficialAssimilated memberAssociated MemberExternal Member

Institution *

—Please choose an option—European CommissionEuropean ParliamentCourt of AuditorsCourt of JusticeEuropean Investment BankOPOCEEuropean SchoolOther

Building *

—Please choose an option—ASPBECHCPEERASEUFO 1EUFO 2HITECJMOKIKADMERCNHEPRESSCHSENTTMTOATOBOTHER

Office phone

Mobile phone

Private address

Street *

No *

Postal Code *

Town *

Phone *

Subscription details:

Membership Card - (€25 per person)Membership Card plus Course fee (€25 + €90 = Total €115 per person)

The membership card is valid for one semester (i.e. from September to January inclusive, or from February to June inclusive.) Your registration is effective upon receipt of your payment. New members have the opportunity to try two lessons before deciding to register.

For the September 2024 semester, payment must be made by 17 October 2024 at the latest.

Level: *

Beginners (Tuesdays 19.00 - 20.30)Bronze (Tuesdays 20.30 - 22.00)Silver (Thursdays 19.00 - 20.30)Gold (Thursdays 20.30 - 22.00)

Please enter the code below:*

Dancing partner (if applicable)

My dancing partner is (Please fill in a separate form for the partner):

Surname

First name

Disclaimer

* I will not hold the Club EURODANSE and/or the members of its Board financially or otherwise responsible for any accident that might occur during any of the activities organized by the Club EURODANSE and/or its members.

* I have made a transfer to the account of the Club EURODANSE via the details as follows:
BIL IBAN Number:  LU36 0028 1026 8240 0000
BIC code: BILLLULL