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Inscriptions 2019-2020 FUN GYM
FUN GYM TOUTES DISCIPLINES VENDREDI 20H00-22H00
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NOM DU GYMNASTE
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Your answer
PRENOM DU GYMNASTE
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Your answer
DATE DE NAISSANCE
*
MM
/
DD
/
YYYY
NATIONALITE
*
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ADRESSE
NPA
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Your answer
COMMUNE
*
Your answer
RUE
*
Your answer
NOM DU REPRESENTANT LEGAL SI MINEUR
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TELEPHONE 1
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Your answer
TELEPHONE 2
*
Your answer
MAIL 1
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Your answer
MAIL 2
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PROFESSION DES PARENTS
PERE
*
Your answer
MERE
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Your answer
SIGNATURE
En cochant cette case ci dessous, je certifie l'exactitude des données ci dessus
Signature
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je valide l'exactitude des données fournies ci dessus
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