29th international meeting ARS ET FIDES – AOSTE (I), 5th - 8th April 2013

REGISTRATION FORM - ( per person ) to be sent to the secretary before 17th February 2013

Generaal Lemanlaan 22 – B - 8310 ASSEBROEK (België) [email protected]

Name & first name …………………………………………………………

Group : ………………………………………….………………………………..

Personal address : ……………………………...….………………………………….

……………………………………………………………………..

Phone : ……………………………… …… mobile : ………………………………

Mail : …………………………..……..……. @ …………….………………………………... (clear writing please)

Arrival : Day : …………………, at (about) ...………….(time) by ………………..(means of transport

Logement :

 I want to stay at the Prieuré

 single room  I share the room with …………………..

 I want to make a reservation for extra nights …………………………………………. (fill out the dates)  I choose to stay at a hotel (and I make the reservation myself)

rates (€) please mark I pay (€) with a x dinner at the Prieuré on Friday 5th April 15,00 lodging on Friday 5th April + breakfast on Saturday 30,00 lunch on Saturday 6th April at the restaurant in Aoste 20,00 dinner at the Prieuré on Saturday 6th April 15,00 lodging on Saturday 6th April + breakfast on Sunday 30,00 festive lunch on Sunday 7th April 25,00 participation in over-all costs (bus transfers included) 26,00 x 26,00 dinner on Sunday 7th April at the Prieuré 15,00 lodging on Sunday 7th April + breakfast on Monday 30,00 excursion on Monday April 8th (lunch included) 23,00 total to be paid please check the total! next page  If you stay at the hotel, please choose one of the two below:,

Hôtel Château Di Cognein Denny & C. S.a.s. Via Libertà N°10, 11010 Saint-Pierre (AO) tel. 0039 0165 903820 fax 0039 0165 903751 www.hotelresidencechateau.com price per person per night (= night + breakfast) individual room = 49 euros; double room = 39,50 euros; triple room = 31,50 euros

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Hôtel Saint Pierre Rue Corrado Gex 61 11010 Saint-Pierre (AO) tel.: 00 39 0165.903817 fax: 00 39 0165.903965 http://www.hotelsaintpierre.it [email protected] prices : please ask the hotel

Departure :

Day : …………………, at (about) ...………….(time) by ………………..(means of transport)

I validate my registration by paying before March 10th the amount of € …………… at Ars et Fides : account number 000-3000006-87 IBAN BE67 0003 0000 0687 BIC BPOTBEB1 Generaal Lemanlaan 22 - B - 8310 ASSEBROEK

At ………………………. on …… / …… / 2013

………………………. (signature)