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INDIVIDUAL REGISTRATION FORM FOR FIBC 2012 OR PRO-AM 2012

FIRST NAME*: LAST NAME*:
COMPANY: FUNCTION:
ADRESS : CITY*:
ZIP CODE: COUNTRY:
GOLF CLUB: CITY:
INDEX: LICENCE NO:
MOBILE NUMBER*: E-MAIL*:
POLO SHIRT SIZE:            S      M      L      XL      XXL
ACCOMMODATION REQUEST / ROOM TYPE      SINGLE      DOUBLE
               


SPECIAL REQUESTS




COST SUMMARY

FRANCE / INDIA BUSINESS CUP WITHOUT ACCOMMODATION

PLAYER..............................................................................................................................1000 €
PLAYER GASSIN..................................................................................................................800 €
NON PLAYER GUEST.......................................................................................................... 500 €


PRO-AM SAINT-TROPEZ WITHOUT ACCOMMODATION

PRO-AM INDIVIDUAL AMATEUR ..................................................................................... 1400 €
PLAYER GASSIN MEMBER ............................................................................................. 1000 €
NON GOLFER GUEST ....................................................................................................... 600 €
TOTAL  

REGISTRATION WILL BE CONFIRMED ONLY AFTER RECEIVING FULL PAYMENT
IN CASE OF CANCELLATION FULL REIMBURSEMENT EXCEPT 200 € BEFORE AUGUST 15, 2012
NO REIMBURSEMENT AFTER AUGUST 15, 2012

HOTEL PARTNERS NEGOCIATED RATES
ROOM BOOKING TO BE DONE BY PSO PRODUCTION AND TO BE PAID DIRECTLY BY GUEST TO THE HOTEL THE DAY OF DEPARTURE

METHOD OF PAYMENT

PAYMENT BY PAYPAL

BANK WIRE TRANSFER
  TO PSO PRODUCTION LTD / EURO ACCOUNT
  ING BELGIUM (BRUSSELS)
  IBAN : BE86 3101 7739 9750
  SWIFT CODE: BBRU-BE-BB