REGISTRATION & HOTEL FORM
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1 6 tthh I n t e r n a t i o n a l C y s t i n o s i s C o n f e r e n c e September 23 26, 2010 Congress Village Ge.Tur. Viale Centrale, Lignano Sabbiadoro (UD) ITALY midway (100 km) between Venice and Trieste REGISTRATION & HOTEL FORM Please register as early as possible, but not later than S e p t e m b e r 1, The registration form shall be sent by (cystinosis@quickline.it), fax ( ) or post (via Santa Caterina da Siena, Trieste (TS), Italy) to QUICKLINE TRADUZIONI & CONGRESSI SECTION A PERSONAL DATA LAST NAME FIRST NAME ADDRESS CITY ZIP CODE PHONE FAX COUNTRY * CODICE FISCALE *A Only for Italian people WRITTEN CONFIRMATION OF YOUR REGISTRATION WILL BE SENT TO THIS E - MAIL ADDRESS
2 SECTION B LAST NAME ATTENDEE INFORMATION FIRST NAME ADULT CHILD AGE GENDER ACTIVITES (Y/N) AFFECTED BY CYSTINOSIS (Y/N) NOTE: CHILD CARE (2 6 YEARS) AND YOUTH ACTIVITIES (6 12 YEARS) ARE PROVIDED, IF REQUESTED, DURING CONFERENCE HOURS. SECTION C HOTEL RESERVATION DATE OF ARRIVAL EXPECTED ARRIVAL TIME DATE OF DEPARTURE EXPECTED DEPARTURE TIME MODE OF TRANSPORT PLANE TRAIN CAR AIRPORT VCE TRS AIRLINE FLIGHT # YES NO YES NO SHUTTLE SEPT, 23 SHUTTLE SEPT, 26 BUS SERVICE ON 2010 BUS SERVICE ON 2010 FROM AIRPORT TO GE.TUR FROM GE.TUR. TO THE AIRPORT ROOMS R ATES (Euros per person) 1 NIGHT 2 NIGHTS 3 NIGHTS SINGLE EUROS EUROS EUROS DOUBLE EUROS EUROS EUROS FAMILY (3-5 beds) EUROS EUROS EUROS CHILDREN 3-6 YEARS IN FAMILY ROOM EUROS EUROS EUROS CHILDREN 6-10 YEARS IN FAMILY ROOM EUROS EUROS EUROS NOTE: ONE NIGHT STAY ONLY: PLUS 20%. CHILDREN 3 TO 6 YEARS OF AGE (NOT COMPLETED) RECEIVE 40% DISCOUNT. CHILDREN 0 TO 3 YEARS OF AGE (NOT COMPLETED) ARE FREE. CHILDREN 6 TO 10 YEARS OF AGE (NOT COMPLETED) RECEIVE 20% DISCOUNT.
3 RATE INCLUDES: BUFFET MEALS (BREAKFAST, LUNCH AND DINNER); TAP COLD WATER IN JUG AT DISPOSAL. RATE DOES NOT INCLUDE: DRINKS DURING MEALS (2.50 EUROS FOR ¼ LITRE WINE, ½ LITRE WATER); MEDICAL ASSISTANCE (10.00 EUROS EACH EXAMINATION); INDOOR OLYMPIC SWIMMING POOL (ENTRY: 2.50 EUROS PER PERSON). SECTION D QUESTIONS TO CYSTINOSIS CONFERENCE SPEAKERS PLEASE LIST ALL THE QUESTIONS YOU WOULD LIKE TO ASK AT THE CYSTINOSIS CONFERENCE. SECTION E T R I P T O V E N I C E (OPTIONAL) TO BOOK A TRIP TO VENICE ON SUNDAY AFTERNOON, 26TH SEPTEMBER 2010, PLEASE FILL IN THE FORM BELOW. TRIP FEE IS EUROS PER PERSON. CHILDREN 0 TO 2 YEARS OF AGE (NOT COMPLETED) ARE FREE. MINIMUM: 30 PASSENGERS. RATE INCLUDES: BUS FROM LIGNANO SABBIADORO TO VENICE PUNTA SABBIONI AND RETURN; PRIVATE CRAFT TO/FROM ST. MARK S SQUARE; TOUR LEADER FOR ALL THE AFTERNOON FROM YOUR ARRIVAL AT ST. MARK S SQUARE AND BACK TO THE CRAFT AND TOURIST GUIDE FOR 2 HOURS. (NOTE: TOUR SUBJECT TO CANCELLATION IF THE MINIMUM NUMBER OF PARTICIPANTS IS NOT REACHED BY AUGUST 30, 2010) HOTELS IN VENICE: HEREINAFTER SOME HOTELS IN VENICE. MORE EXAMPLES ON LOCANDA ANTICA VENEZIA ***, 100 MT FROM ST. MARK S SQUARE, CITY CENTRE, RATES FROM EUROS FOR A DOUBLE ROOM, BB. HOTEL CAVALLETTO E DOGE ORSEOLO ****, 100 MT FROM ST. MARK S SQUARE, CITY CENTRE, RATES FROM EUROS FOR A DOUBLE ROOM, BB. ANTONY HOTEL ****, 3.6 KM FROM VENICE AIRPORT, RATES FROM EUROS FOR A DOUBLE ROOM, BB. RUSSOTT HOTEL VENEZIA SAN GIULIANO ****, 6 KM FROM VENICE AIRPORT, RATES FROM EUROS FOR A DOUBLE ROOM, BB. SECTION F SUMMARY PLEASE, SPECIFY THE NUMBER OF PEOPLE (BOTH ADULTS AND CHILDREN) ATTENDING THE CONFERENCE, THEIR HOTEL RATES AND THE TOTAL FEE TO BE PAID FOR. ATTENDEES No. RATES ADULTS CHILDREN 3-6 YEARS CHILDREN 6-10 YEARS TRIP TO VENICE EUROS TRIP TO VENICE (0-2 YEARS) EUROS TOTAL FEE
4 SECTION G CREDIT CARD PLEASE DEBIT MY METHOD OF PAYMENT MASTERCARD VISA FOR THE AMOUNT OF EUROS CREDIT CARD HOLDER CARD NUMBER EXPIRY DATE CARD SECURITY CODE DIRECT BANK TRANSFER TO: BENEFICIARY: QUICKLINE SAS BANK: UNICREDIT BANCA IBAN CODE: IT 76 J SWIFT CODE: UNCRITB1884 REFUNDS CANNOT BE GUARANTEED FOR CANCELLATIONS MADE AFTER 30 AUGUST CANCELLATIONS BEFORE THIS DATE WILL BE SUBJECT TO A HANDLING FEE OF EURO SECTION H PRIVACY (ITALIAN ATTENDEE ONLY) INFORMATIVA AI SENSI DELLA PRIVACY AUTORIZZO IL TRATTAMENTO DEI MIEI DATI PERSONALI AI SENSI DELLA LEGGE SULLA PRIVACY DLGS 196/2003 E S.M. FIRMA PER ACCETTAZIONE SECTION I USEFUL INFORMATION HOW TO ARRIVE TO LIGNANO BY PLANE THERE ARE 3 INTERNATIONAL AIRPORTS IN THE SURRONDINGS OF LIGNANO. TRIESTE, VENICE AND TREVISO. ARRIVAL: A SHUTTLE BUS SERVICE WILL BE ORGANIZED FROM VENICE, TREVISO AND FROM TRIESTE AIRPORT TO GE.TUR. VILLAGE AT SEVERAL HOURS ON SEPTEMBER, 23. DEPARTURE: A SHUTTLE BUS SERVICE WILL BE ORGANIZED FROM GE.TUR. VILLAGE TO VENICE, TREVISO AND TO TRIESTE AIRPORTS. PUBLIC SHUTTLE BUSES ALSO CONNECT LIGNANO TO BOTH AIRPORTS: - RONCHI DEI LEGIONARI (TS) LIGNANO: - MARCO POLO (VE) LIGNANO:
5 BY CAR REACH LIGNANO TAKING A4 VENICE - TRIESTE MOTORWAY OR A23 TARVISIO - VENICE; THE EXIT FOR LIGNANO IS LATISANA, THEN TAKE THE LOCAL ROAD N. 354 TO LIGNANO SABBIADORO. BY TRAIN/BUS LATISANA TRAIN STATION IS JUST 20 KM FAR FROM LIGNANO. FOR EXAMPLE THE TRAVEL FROM MILANO CENTRAL STATION TO LATISANA STATION TAKES 4 HOURS AND COSTS AROUND EUROS, AND THE ONE FROM VENEZIA STATION TO LATISANA STATION TAKES 1 HOUR AND COSTS 5.00 EUROS. FOR MORE INFORMATIONS SEE THE WEB SITE REGULAR BUS LINES CONNECT LIGNANO TO LATISANA (UDINE-MUZZANA LATISANA-LIGNANO: THE TRIP TAKES 26 MINUTES FROM LATISANA STATION TO THE STOP IN FRONT OF GE.TUR.: V.LE CENTRALE-COLONIE ). BUSES RUNNING TIMES: FROM 8.30AM TO 8.20PM. ON REQUEST, THE TIME TABLE WILL BE SENT BY . TOURIST ATTRACTIONS IN LIGNANO PARCO ZOO PUNTA VERDE VIA SCERBANENCO, 19/1, LIGNANO SABBIADORO (UD) THE ZOO PARK OCCUPIES AN AREA OF 100,000 SQ. M. SET IN A LOOP OF THE RIVER TAGLIAMENTO, AND HOSTS OVER 1,000 ANIMALS BELONGING TO 200 DIFFERENT SPECIES. RATES FROM 9.00 EUROS FOR CHILDREN (FROM 3 TO 11 YEARS) TO EUROS FOR ADULTS. JUNIOR PARK VIALE CENTRALE LIGNANO SABBIADORO (UD) A LARGE PLAYGROUND IN LIGNANO SABBIADORO SET IN THE GREENERY WITH FOUNTAINS AND SMALL LAKES RICH IN LOCAL FLORA AND FAUNA. A PLACE FOR GAMES IN TOTAL FREEDOM AND SECURITY. QUALIFIED ENTERTAINERS WATCH AND FOLLOW THE CHILDREN AT THE GAMES. MINICRUISES EXCURSIONS ALL YEAR ROUND. VISITS TO THE REGIONAL NATURE RESERVE "FOCI DELLO STELLA".
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