v.z.w.  Eyebus  a.s.b.l.

EYEBUS ... Prevention against blindness

SUBSCRIPTION BIKETOUR 2018 2GETHER4VISION

Interested people can subscribe by the subscription form. They will receive a confirmation email and all the necessary information. The subscription is only valid after the reception of the amount of subscription on the account of 'non-profit association Eyebus', account number BE36 7310 4449 4881, with in the statement the NAME OF THE PARTICIPANT AND THE MENTIONNING SUBSCRIPTION BIKETOUR 2018.
If there is cycling with a tandem, both the guide and the passenger have to subscribe a subscription form.

Individually
With tandem together with

I cycle

Sighted
Blind or visually impaired

I am

Name: First name:
Date of birth:
Street:     House Number:
Postal code:   Township:
Telephone or mobile phone:
Email:
XXL
XL
L
M
S Size cycling jersey
No
Yes (I will pay the supplement of 60 €)I want a single room
Without preference of partner
With preference of partner: I want a twin room
Remarks:
Telephone number of person to contact in case of emergency:

General conditions (PDF document)

I accept the conditions



I deposit the dued amount (see price list) on the account of 'non-profit association Eyebus', BE36 7310 4449 4881, with in statement my NAME and SUBSCRIPTION

 

 

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