Staff Registration Maltacamp 2020
1. First name (as shown on passport/ID) *
Your answer
2. Family name (as shown on passport/ID)* *
Your answer
3. First and family name as you would like them shown on your badge *
Your answer
4. Gender *
5. Date of birth (must be 18 years and older by July 29th, 2020) *
MM
/
DD
/
YYYY
6. City *
Your answer
7. Country *
Your answer
8. Email *
Your answer
9. Phone number (include country code, e.g. +39) *
Your answer
10. Identification document type *
11. Identification document number *
Your answer
12. Identification document valid until *
MM
/
DD
/
YYYY
13. Health Insurance *
During Maltacamp you need your European Health Insurance Card or adequate Health Insurance, which covers you in Italy. Furthermore, we recommend to take a travel insurance, which includes medical repatriation
14. Health insurance company *
Your answer
15. Health insurance number *
Your answer
16. Dietary requirements *
Required
17. T - shirts size male
18. T - shirts size women
19. Emergency contact: First name *
Your answer
20. Emergency contact: Family name *
Your answer
21. Emergency contact: email *
Your answer
22. Emergency contact: phone number (include country code, e.g. +39) *
Your answer
23. Emergency contact relation to you *
Your answer
24. Emergency contact: languages spoken and understood *
Required
25. Infectious disease (Hep C, HIV, MRSA, TBC) *
Required
26. Vaccinations: please make sure that your vaccinations are up to date *
27. Date of last tetanus vaccination *
MM
/
DD
/
YYYY
28. Fears (Height, water, animals, etc)
Your answer
29. Anything else we should know
Your answer
30. Languages spoken *
Not spoken
Basic
Intermediate
Advanced
English
Italian
German
Spanish
French
31. Have you had other experiences with the Order of Malta? *
32. If you answered "yes" to the previous question: what experiences did you take part in? *
Your answer
33. Additional skills
Please tell us if you have particular skills that can be useful for the camp (ex: plumber, electrician, engineer, etc.)
Your answer
34. Consent *
We collect and use your personal data, which you provide in this registration form for the purposes described in our Privacy Policy, which has been sent to you alongside the link to this registration form. Our main purpose for using your data is to prepare and conduct the Maltacamp 2020. For some processing of your data we need your consent.Unless indicated otherwise, you are free to refuse to give consent and this will have no negative impact on your participation in the Maltacamp 2020. Even after giving consent, you can withdraw your consent at any time with effect for the future, as described in the Privacy Policy.
35. Privacy Policy *
I have read and understood the Privacy Policy of the Italian Association of the Sovereign Military Order of Malta ("Order of Malta Italy") for the Maltacamp 2020, which has been sent to me alongside the link to this registration form.
36. Use of personal data, including medical data *
Give consent to sensitive data - in particular health related data which I have disclosed - being collected and processed by the Order of Malta Italy for the purpose of conducting the Maltacamp 2020. Understanding that, as a guest, it is not possible to participate in the Maltacamp 2020 without giving this consent due to the reasons given in the Privacy Policy. Agree to the Order of Malta Italy receiving important medical or support information from the emergency contact and the general practitioner to ensure a safe and adequate stay. If applicable, to release my general practitioner and the person to be contacted via the emergency contact from his/her professional secrecy in this respect. Understand that, as a guest, I cannot participate in the Maltacamp 2020 without giving consent due to the reasons given in the Privacy Policy.
37. Name, Photographs, Video, Sound Recording *
Give consent to my name and identity being revealed by the Order of Malta Italy on social networks, Order of Malta Italy websites, prospectus, news articles and other printed material as well as film and audio contributions to be broadcast or published for the purpose of informing and reporting about and promoting camps and other activities conducted by the Order of Malta Italy and the Maltacamp 2021 conducted by the Order of Malta Belgium.Agree that the Order of Malta Italy may take, (re-)use, (re-)publish and otherwise process photographs, videos and sound recordings (“Material”) where I can be depicted alone or together with others. This in particular includes making the Material available on its websites, on social networks (such as Facebook), prospectus, news articles and other printed material as well as film and audio contributions for the purpose of informing and reporting about and promoting camps and activities organized by the Order of Malta Italy and for the promotion of the Maltacamp 2021 by the Order of Malta Belgium. As far as references to ethnicity, religion or health can be derived from the use of the material (e.g. skin color, clothes, glasses, and disabilities), this consent also applies to these details.
38. Age declaration *
I confirm that I will be over 18 years old by July 29th 2020
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