JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration for the virtual walking challenge
Please fill out this form and pay the amount due by a bank transfer.
After registration we will send you all details on how to become a member of our ZontaWalk club on Strava, where we will follow the efforts of all the participants. We will also share our joint progress on our facebook-page.
Don't forget to click the 'submit'-button
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name and surname
*
Your answer
Are you a Member of a Zonta Club?
*
yes
No
If you answered 'yes', please fill out the name of your club here.
Your answer
IMPORTANT : Don't forget to transfer €10 on the account of Zonta Waasland Service with IBAN : BE75 7370 2541 4851 (BIC : KREDBEBB)
The full amount, raised by this virtual walking challenge, will be donated to the ‘Let us Learn Madagascar’ project.
Your data are only used for information purposes concerning this event and won't be passed on to third parties
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
