Yachad Platinum Meeting in Budapest

Mr / Mrs / Ms:

Surname:

Middle Name:

First Name:

Mailing Address:

Email:

Tel:

Cell Phone:

City:

Country:

Zip Code:

male female

Date of Birth:

ACCOMODATION

The registration fees below include four nights’ hotel accommodation (Wednesday to Sunday) meals (dinner), excursions and parties. N.B.
Meals will be fish and vegetarian. Kosher will be serve only Friday evening.

The programme will begin on Wednesday evening and ends Sunday midday.

I would like to share a room with:

Single Room € 725,-
Double Room € 495,-

Remarks:

PAYMENT

CREDIT CARD

We accept Visa, and MasterCard.

Credit Card:

VISA MasterCard

Card Number:

Valid until:

/

Name on Card:

BANK TRANSFER

Gady Gronich, Isartalstr. 34, D-80469 Munich, Germany
Postbank Munich, acct. no. 804-24-804, Bank Code 700 100 80, Swiftcode PBNKDEFF700, reference "Yachad Budapest 04”

To ensure a place, please fax or Email the registration form to Gady Gronich at the number given below. If you require further information, contact Gady in Munich. In English, German or Ivrit.

Cancellations:
In case of cancellation prior to April 23, 2004 there will be no cancellation fee, after that date we will charge 100% cancellation fee.

I hereby authorize you to charge my credit card as stipulated above.

You can also download the Registration Form and Fax it to: Gady Gronich Fax Nr. +49 (0) 89 44 45 43 55

Registration Form