REGISTRATION FORM 

The National Federation of ________appointed the following delegates to attend the World Endurance Forum: 

1.     Name, First name: ________________   Email address : ____________

Function represented:     Technical Delegate  /   Judge   /   Veterinarian 

2.     Name, First name: _________________  Email address : ___________

 Function represented:     Technical Delegate  /   Judge   /  Veterinarian 

3.     Name, First name:  _______________  Email address : ____________

Function represented:     Technical Delegate /    Judge  /  Veterinarian 

NF Official Representative:         
                                          Stamp and
Date:                                Signature:         

Registration fee: 75 CHF/person  

(Must be paid by closing date of registration to confirm participation – Please mention “World Endurance Forum” with your payment) 

Payment options: 

1. Bank transfer 
Bank           UBS SA, 1002 Lausanne, Switzerland
Account holder Federation Equestre Internationale
IBAN            CH53 0024 3243 G051 8709 0
Account       243-G0518709.0
BIC              UBSWCHZH80A 

2. Payment by VISA (only) 
Name and surname of holder
Card number
Amount
Country of issue  

3. Cheque  
Payable to:
Fédération Equestre Internationale
Avenue Mon-Repos 24
1005 Lausanne
Switzerland 

Please return this form no later than 10 March 2007 to Emilie Leyvraz (email: e.leyvraz@horsesport.org  fax: 0041 21 310 47 60).