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- Title of presentation:………………………………………………………………………………………………

Use without restriction

- Title of presentation:………………………………………………………………………………………………

Use without restriction

- Title of presentation:………………………………………………………………………………………………

Use without restriction

- Title of presentation:………………………………………………………………………………………………

Use without restriction

………… (Initials please)

To the best of my knowledge, my presentation does not infringe any proprietary or personal

rights of others (including any copyright, trademark and privacy rights), is factually accurate,

and contains nothing defamatory or otherwise unlawful. Brief quotations from a lawfully

published work for the purpose of education or in the frame of scientific activities don’t

infringe the copyright, when they are made conform fair professional practice and serve the

intended target. These quotations should however always mention the source and the name

of the author.

……….. (Initials please)

I warrant that my presentation and/or the related materials fully comply with all applicable

laws and statutes, and shall not infringe upon the intellectual property rights, the right of

personality, or any other right, title or interest, of any third party.

The law applicable to this Agreement is Belgian law. In case of dispute, Belgian courts will

have exclusive jurisdiction.

I have read the Agreement above, initialed and accept this agreement.

……………………………………………………………………………………………………………………………………

Signature

……………………………………………………………………………………………………………………………………

Date

Email completed form to EMAIL OF PERSON IN CHARGE OF THE COURSE or fax +32 2 779 54 94.