1 Start 2 Complete Full name * Phone number * Email address * Emergency Contact * Please provide full name, relationship, and contact number including country code. ESN Section * - Select -ESN AberdeenESN AberystwythESN BristolESN City LondonESN CoventryESN DurhamESN EdinburghESN ImperialESN LeedsESN NewcastleESN Oxford BrookesESN QMULESN RGUESN SouthamptonESN StrathclydeESN UofGOther Which ESN section are you coming from? If none from this list, please select 'other'. Ticket Type * - Select -AberdeenNewcastleBirminghamManchesterBristolLondonAberystwythAccommodation and activities only [NO TRANSPORT]Activities only [NO ACCOMMODATION OR TRANSPORT] Which ticket type are you purchasing? Note: for ticket types including transport, the locations given will be the pick-up and drop-off points for the included travel. If you have selected 'other', please specify how you heard about this event. Dorm Gender Preference * - Select -MixedAll maleAll femaleNo preference Participants will be accommodated in dorm rooms in hostels. Please state preference between all female, all male, mixed, or no preference for your room. Group/Roommate Preference Please use this space to inform us if you are buying tickets with someone else, and would like to be in the same dorm/group with them. We will do our best to accommodate this but it cannot be guaranteed. Do you have any impairments (e.g. visual or hearing) or accessibility/mobility requirements we should be aware of? * Yes No If you have selected 'yes' above, please specify. Do you agree to act in accordance with the ESN Code of Conduct throughout the event? * - Select -Yes Found at https://esn.org/sites/default/files/code_of_conduct.pdf Do you consent to share the data entered in this form with the event organisers in order to facilitate logistical matters? * - Select -Yes All data will be treated in line with GDPR. Do you consent to the use of photographs taken during this event? * - Select -Yes By consenting, you grant Erasmus Student Network UK full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve their aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications. Do you consent to be contacted in relation to this event? * - Select -Yes Including emails from event organisers, and being added to a group chat for all trip participants. Do you agree to the disclaimer below? * - Select -Yes I understand that participation in trip activities could involve risk of physical injury, illness, death or property loss, and despite safety precautions, the organisers cannot guarantee the safety thereof, as all risks cannot be prevented. ESN UK does not provide health and accident insurance for trip participants, and I understand that any medical expenses, property loss, or other personal expenditures that result during or from this travel/trip are to be borne by myself as the participant. I also hereby consent, give authorisation to, and release from liability; trip leaders to secure any emergency medical treatment in the event I am unable to, and I agree to be responsible for the costs thereof. I acknowledge that I will not seek to have ESN UK held liable in the event that any accident, injury, loss of property or any other circumstance or incident occurs during or as a result of my participation in the trip. This release of liability includes accident, injury, loss, or damages to myself, as well as to other individuals or property which may result from my participation in the event. I hereby release and agree to hold harmless ESN and its members from any claims arising out of my participation in the trip. I understand that this trip is non-refundable, but I may transfer my spot by name change until 3rd November 2023. Is there anything else you would like us to know?
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