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Sport and cultural linguistic stays for adults and teenager
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SPORT, SOCIAL
AND CULTURAL ACTIVITIES
Language study holiday for adults and teenagers
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Registration

This is an official registration form for BLCI classes.
Please complete the below registration form and submit it.

Boxes with a star * must be completed

Formulaire
Civility * :
 
Surname * :
 
First name * :
 
Address * :
 
Postal code * :
 
City * :
 
Country * :
 
Phone number * :
 
Mobile :
 
Fax :
 
E. mail * :
 
Date of birth :
 
Nationality :
 
     
COURSE
     
Which formulas of course choose ? * :
How many weeks ? * :
 
Dates of your stay :
  From * : To * :
Your level in french ? * :
 
     
ACCOMMODATION
     
Which lodging choose ? * :
Date of arrival in the family ? :
Date of departure of the family ? :
Which hotel ? :
 
    If you wish that we undertake the reservation, do not hesitate to give us information :
Nunber of nights, single room ...
 
Are you ? : Vegetarian Smoker Allergies
If you have allergies, tell us which ? :
     
TRAVEL
This information is indispensable for the host family.
How and when will you be arriving (date + time) ? :
     
  Airplane
    Airline company :
    Flight N° :
     
  Train
    Departing from :
    Train N° :
     
  Car
    Hour of arrival :
     
UNDER 17 STUDENTS
     
    I undersigned gives the authorization to B.L.C.I. to make practise a hospitalization or any other medical act, if necessary by a competent doctorAs a relative let us take we all the responsabilities for them.
     
Boxes with a star * must be completed
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BLCI - 26 bis Avenue Voltaire 64200 Biarritz - Tél. 00 33 667 939 534 - Mail : contact@blci64.fr