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PARTICIPANT’S ORGANISATION ADDRESS
PLEASE DESCRIBE YOUR WORK OR RESPONSIBILITY IN YOUR ORGANISATION (MAXIMUM 5 LINES):
PLEASE STATE YOUR INTEREST AND MOTIVATION FOR ATTENDING THIS TRAINING COURSE (MAXIMUM 5 LINES): Please take note of the following conditions that will apply if you are selected to take part in the «Answers in the Mirror» training course:
I commit myself to participate in the whole process, including: - to prepare myself carefully for the training course - to take part in the full duration of the training course - to participate in the whole evaluation process
I am aware that obtaining a health and a full travel insurance are my own responsibility and at my own expenses. I understand that the information provided on my special needs does not remove my own personal responsibility for ensuring my own health.
I authorise the teamers to publish, in whatever form and by whatever medium, including the internet, the outcomes of the «Answers in the Mirror» training course and the pictures taken during the «Answers in the Mirror» training course.
Place: Date: Signature:
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