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Security Form

Please fill out the following form if you plan to attend softball games, practices, and/or events at Bucker Field or Higgs Field during the year, whether as an active participant or as a guest. The data from this form is kept strictly confidential. It is used by the security personnel at the fields to keep track of people and vehicles entering the site. CERN Softball Club members are asked to fill in a Club Membership Form instead of this form.

All bold fields must be filled in. If you have any questions or comments, please mail them to Softball.Club@cern.ch. Thank you.

Bucker and Higgs Field Security Information

Given (First) Name:
Family (Last) Name:
E-mail Address:
(choose one)
Passport Number(last 4 digits):
Primary Transportation:
(choose one)
Secondary Transportation:
(choose one)
Country of Primary License Plate:
(choose one)
Country of Secondary License Plate:
(choose one)
Number of Primary License Plate:
Number of Secondary License Plate:

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Last modified: Tue Apr 19 09:30:51 CEST 2011