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Rotary International
8th District 2452 Conference
Manama, Bahrain 27th to 29th May 2021
REGISTRATION FORM
PLEASE FILL THE BELOW FORM
Primary Participant
Country
Bahrain
United Arab Emirates
Jordan
Lebanon
Sudan
Cyprus
Georgia
Armenia
Palestine
Others
Select Category Type
Rotarian
Rotaractor
Interact
First Name :
*
Family Name:
*
Club Name:
*
Call Name
(For Badge)
Rotary Title
DG
PDG
DGE
DGN
DGD
AG
AGC
P
PP
RTN
Other
Gender :
Male
Female
Contact No :
*
Mobile No :
*
Office No :
Fax No :
Your Email Id :
*
Profession :
Spouse, Family Member , Friend
Select Category Type
Spouse
Family
Friend
First Name :
*
Family Name:
*
Club Name:
*
Call Name
(For Badge)
Rotary Title
Gender :
Male
Female
Contact No :
Mobile No :
Office No :
Fax No :
Your Email Id :
Profession :
Guest Family Name :
First Name:
Call Name:
(Call Name For Badge)
Registration Fees
Virtual Attendance
(Non Refundable Admin Fee)
Physical Attentance
Number of Persons
Amount in USD
Rotarian
USD 25
USD 500
USD 25
Spouse & Guest
USD 25
USD 500
Rotaractor
USD 25
USD 200
Interactor
Nil
USD 200
Reset Selection
Total Registration Fees (in USD)
USD 25
Trip Details :
Arrival Date :
Departure Date :
Arrival From :
Departure To :
Flight Number :
Flight Number :
Arrival Time :
Departure Time :
Choose Payment Option :
Credit Card
For more information kindly visit
https://www.bahrain2021.com/
Please return the form duly filled to email
bahrain2021conference@gmail.com
Register
