SI
Sustainable Industries-Europe:
Accelerating the transition towards sustainable business
practices in European industries
EUROPE
Registration Form
Please send the registration form via scan to info@si-europe.com or via fax to 0032 2 808 43 99
 Please tick your choice

Pre-Conference training by REACHReady

Date
6th March 2013
Fees in EURO
€
480,-
One-day Conference per participant
7th March 2013
€

One-day Conference per participant
8th
€
540,-

Two-day Conference per participant
7th and 8th March 2013
€
1080,-

Gala Dinner per participant
7th March 2013
€
75,-
March 2013
Early bird 15% discount for booking before 2013, January 31
st
Total
540,-
-15%
Total amount payable* €
* All prices exlc. VAT (21%)
Venue: HUSA Hotel Brussels and Gala dinner ceremony at the Parkside 24 (Avenue de la Joyeuse Entrée) in Brussels.
Please complete this form in BLOCK CAPITAL LETTERS
First name
Family Name
Company
Job title
Street number
Code
City
State
Country
Invoicing address (in case of different address)
Phone
Email
Fax
VAT number (for companies in the EU)
Date
Signature and acceptance of conditions
Payment
 Please invoice my company
Purchase Order No.:
 Please charge to my credit card
 VISA
Name on card:
 Mastercard
Card No.:
 AMEX
Exp. Date:
CVC Code:
/
Registration Conditions and requirements:
The fees include digital documentation as well as refreshments, lunch for the dates 7th, 8th (6th in case of pre-conference training) and the optional social event or gala dinner. Discounts: only one discount
available per person. A confirmation of registration and an invoice will be sent to you as soon as your registration is received. Prices are exclusive VAT. If you do not re ceive a confirmation, please call us to
ensure we have registered your booking. SI-Europe is a Genisi sprl/bvba trademark. Genisi sprl will not be liable for any non-arrival of your registration information. The issued registration fee is payable within
10 days after date of invoice. Places are only guaranteed when payment is received. Cancellations are possible in writing before or on February 15th, 2013 and will be subject to an administration charge of 25%
of the registration fee. It is regretted that after February 15th, 2013 no refunds are possible. You must notify Genisi sprl in writing of a cancellation before or on February 15th, 2013 otherwise we will be
obliged to charge the full fee. Substitutions are permitted at any time before the event. Payments not fully received before the event may result in entry being denied. In case of cancellation of the event by
Genisi sprl, liability will be limited to the return of fees actually paid. No responsibility is assumed by Genisi sprl, the organizer or the speakers / authors for any injury and / or damage to persons or property as
a matter of product, negligence or otherwise, or from any expectation regarding the event, use or operation of any methods, products, instructions or ideas presented at the event or contained in the notes. No
recording or picturing on the premises of the conference is allowed during the conference without prior written consent of the organizer. In case of a person (delegate, exhibitor, visitor) infringing the overall
interest/aim of the conference or infringing the interest of other delegates, companies or parties involved in the conference the organizer is entitled to exclude the infringing person/company from the show
after a warning (written or personally by the conference director) showed no adequate result. All respective costs in context of the infringement or the exclusion are on the infringing persons/companies own
responsibility. No liability in any way or any reason is taken by the organizer in this case. Admission shall be refused if financial commitments relating to a contract with Genisi sprl remain un-honored. We point
to the fact that e.g. travels arrangements, adequate insurance cover as well as possible visa procedures are on the delegate’s own responsibility. While every effort will be made to adhere to the published
program it may be necessary for reasons beyond the control of the organizers to alter the content and timing of the program or the identity of the speakers without notice. Please check the website for the last
version of the program. The personal information on this form provided by you will be held on database and used for communication matters. In some cases related to the general idea of the conference your
details may be made available to external companies for marketing purposes. If you do not wish your details to be used for this purpose please tick the box 
The cost of accommodation is not included in the registration fee. However, rooms are available on a special rate at SI-Europe website (www.si-europe.com) in the event page. Please note that early
registration is recommended as places at this event are limited. Registration deadline: February 28th, 2013 if not booked up earlier. After that date, places are subject to availability. In addition to the provisions
mentioned above this contract is subject to the law of Belgium. For further information please contact: Enela Tanka Tel: +32 488 81 29 78 E-mail: info@si-europe.com and visit us at: www.si-europe.com