Balint Weekend 2020, Hungary - Application Form

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Hungarian Balint Group Weekend
Date: 11--13th September 2020, Érd, Hungary
Location: Regina Mundi Cloister, 2030 Érd, Tárnoki út 11.

Early bird application until 9th August 2020 (with filled form +bank transfer)!

PLEASE GIVE your contact EMAIL below.

Name *

Birthdate (Month, Day, Year) *

YYYY

Profession, field of activity *

Address *

Contact (phone)

Application for... *

2 days (Friday, Saturday) = 1 night, 3 meals (Fri dinner, Sat breakfast, lunch), Balint groups

3 days total (Fri, Sat and Sunday) = 2 nights, 6 meals (see as above plus Sat dinner, Sun breakfast, lunch)

Single one-bed room for extra fee or the default 2/3 people per room accomodation? *

Single room (extra 12 EUR/night)

2 or 3 people in one room accomodation

No accomodation required

Roommates' names if agreed between each other

Beside the basic participation and price, I would like to order

lunch for Friday (+6 EUR)

dinner for Saturday (+6 EUR), an option only for 2(two)-day applicants!

Questions, requirements (e.g. special diet, allergies)

I would like a transfer from Érd alsó train stop on Friday afternoon: trains departs from Déli pályaudvar, Budapest (South Railway Station, onthe underground line Red M2) towards ‘Érd alsó’ stop at 10 and 40 minutes in every hour. Our team can pick you up at the train stop Érd alsó, if you prefer that. This is a free service. *

Yes, I would like a transfer from the train stop.

No, I get there by myself.

Data for INVOICE - NAME (If necessary, institute or company name)

Data for INVOICE - ADDRESS (If necessary, give the institute/company address and other required data)

REGISTRATION FEES and OPTIONS

The total price should be transferred to the bank account of the Hungarian Balint Society:
ACCOUNT OWNER - Magyarországi Bálint Mihály Társaság;
BANK name and address - OTP BANK NYRT. BUDAPEST 1061. Andrássy út 6.;
ACCOUNT NUMBER - IBAN: HU57 1178 6001 2006 0738 0000 0000; BIC (SWIFT): OTPVHUHB.
Please add your NAME and BIRTHDATE as a note for the transfer!
The registration becomes valid by the payment of the registration fee.

Payment method *

Bank transfer until 9th August

Bank transfer AFTER 9th August

After September 6th just by cash on the spot

EARLY BIRDS until 9th August

3 days total, full price (105 EUR)

2 days, full price (75 EUR)

+ dinner for Saturday (+6 EUR), option only for 2-day applicants!

+ lunch for Friday (+6 EUR)

+ single room 1 night (+12 EUR)

+ single room 2 nights (+25 EUR)

- I do not require accomodation (2 days, 1 night) -6 EUR

- I do not require accomodation (3 days, 2 nights) -12 EUR

LATELY BIRDS after 9th August

3 days total, full price (120 EUR)

2 days, full price (90 EUR)

+ dinner for Saturday (+6 EUR), option only for 2-day applicants!

+ lunch for Friday (+6 EUR)

+ single room 1 night (+12 EUR)

+ single room 2 nights (+25 EUR)

- I do not require accomodation (2 days, 1 night) -6 EUR

- I do not require accomodation (3 days, 2 nights) -12 EUR

Balint Group experience

How, where do you hear from the event? *

from an official platform of a Balint Society (website, Facebook, direct email)

from a (professional) newsletter, forum, website 'second-hand'

from a friend or colleague

Other:

Required

I hereby provide my consent as a Participant of the Balint Weekend 2020, that my personal data given here can be handled by the event organizers. The lawful basis on data processing is the European Union GDPR Act (https://en.wikipedia.org/wiki/General_Data_Protection_Regulation) and your consent.
Data retention period: from your registration until 31 May 2021 (the closure of the tax year 2020 in Hungary).
We ensure the data security and protection by laws of Hungary and the EU-GDPR. Responsible person for data management: the President of the Hungarian Balint Society, the Head of the Organizing Committee, Katalin Dobó MD. The Society's Secretary and Treasurer are also can process the data collected.
Our purpose for data processing: organizing the conference, communication with participants. Data processing methods: store, copy, print or edit the registration data if necessary; partly automatised, partly personally.

I am aware of my rights about data management: the right to be informed; of access, to rectification; to erasure; to restrict processing; to data portability; the right to object; and to not to be subject to automated decision-making including profiling.
About affairs, questions of data management please write us an email: balinttarsasag@gmail.com
You also have the right to complain to the Hungarian Office for Data Protection, if you feel there is a problem with the way we are handling your data. Then you can contact the Nemzeti Adatvédelmi és Információszabadság Hatóság - https://www.naih.hu/uegyfelszolgalat,--kapcsolat.html

I hereby certify that I have read and understood our Privacy Policy above. I accept the conditions on data management. (We need your consent to validate your registration.) *

I accept the conditions.

I do not accept them.

Do you accept the sharing of photos and videos taken during the event (evidently not in the Balint Group sessions)? *

Yes, even for public sharing.

Yes, but just for the participants present at the Weekend.

No, I don't accept it. (Any photo or video taken of me should be deleted.)

Thank you for the registration!

Your registration will be validated by sending this form AND paying your total registration fee by bank transfer.

We do look forward to meet You at our Balint Weekend 2020 in Érd, Hungary!
The Organizing Committee

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