Congreso Internacional de María Auxiliadora
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Registration form

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Personal data

First name *
Last name *
Birthdate *
Nationality *
Identity document type *
Number *

Group data

Individual or Group Registration *
Group name
Name and Surname of reference

Residence data

Country *
Location *

Contact information

e-Mail

Phone number

Pref. intl.
Number

Mobile phone number

Pref. intl.
Number

Salesian family data

Do you belong to a branch of the Salesian family?

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Indicate which one
Salesian House of belonging

Language data

Select the language (s) in which you wish to receive simultaneous interpretation

Spanish

Italian

English

Portuguese

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Spanish

Italian

English

Portuguese
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Health tab data

Do you have any medical issue that requires special attention?

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Usual medication

Are you allergic to any medication?

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Are you allergic to any food?

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Are you allergic to something else?

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Do you require an special diet? *

Indicate the reason

Celiac

Hypertensive

Diabetes

Vegetarian
Other reasons

Contact person to turn to in case of an emergency

First name *
Last name *

Mobile phone number

Pref. intl. *
Number *
Relationship *
¿Travel with you? *

Foreign

Do you have medical assistance to traveler?

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Medical assistance phone

You have some mobility restriction?

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Contacto

mariaauxiliadora2019@donbosco.org.ar