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QUESTIONNAIRE INSCRIPTION 2022-2023
Inscription Club de Judo AL ST BRIEUC
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Email
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Your email
NOM DU LICENCIE
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PRENOM DU LICENCIE
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Your answer
NOM DE JEUNE FILLE (uniquement pour les femmes mariées)
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DATE DE NAISSANCE DU LICENCIE
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MM
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DD
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YYYY
LIEU DE NAISSANCE
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NATIONALITE
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SEXE DU LICENCIE
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FEMININ
MASCULIN
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POIDS DU LICENCIE
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ADRESSE DU LICENCIE
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CODE POSTAL
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VILLE
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TELEPHONE DU LICENCIE OU DE SON REPRESENTANT LEGAL
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LE LICENCIE EST IL MINEUR AU MOMENT DE L'INSCRIPTION
MINEUR
MAJEUR
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