Registration form Send by fax to +49 341 3559-2016 or email to [email protected] Last Name, First Name* Institution Email* Address* Phone Number Privacy Policy Any personal data collected during the registration process will only be stored and used by Leipzig + Kultur e. V. as necessary for the purpose of this event and will not be made accessible to any third party. □ I would like to be added to Leipzig + Kultur e. V.’s invitation mailing list. I will take part in □ the podium discussions on September 23rd and 24th, 2015 □ the Workshop »Handlungs.Spiel.Räume« on September 25th, 2015, from 10 am to 6 pm □ the Workshop »Teilen & Haben« on September 25th, 2015, from 10 am to 6 pm □ 6 pm the Workshop »Auseinandersetzen Zusammensetzen« on September 25th, 2015, from 10 am to □ the Workshop »Kultur bildet!« on September 25th, 2015, from 10 am to 6 pm I am aware and agree that visual and audio recordings for documentation and publicity purposes will be made during the event and that my name and my organisation will be included in the list of participants of this event. The list should also include the following information: □ My Email □ My Phone Number (please provide your number above) I have read and agree to the Registration Information (www.kultur-standort-bestimmung.de). Place, Date Signature * Fields that are essential for registration are marked with an asterisk. We kindly ask you to provide this information.
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