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INTERNATIONAL HAINAUT CUP 2020 : U15 Filles
FORMULAIRE D'INSCRIPTION
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Samedi 03 octobre 2020 - Saterday october 3rd, 2020 - Zaterdag 3 october 2020
Participation 10,00€ - Registration 10,00€ - Inschrijving 10,00€
Paiement sur le compte n° BE72 0882 6437 5616
BIC : GKCCBEBB
LICENCE
*
Numéro Licence - License Number
Your answer
NOM
*
Your answer
Kyu - Dan
*
Choose
3 KYU
2 KYU
1 KYU
1 DAN
2 DAN
Autres - Others - Ander
DATE DE NAISSANCE
*
Année de naissance - Year of birth - Geb. jaar
MM
/
DD
/
YYYY
POIDS
*
- 32 KG
- 36 KG
- 40 KG
- 44 KG
- 48 KG
- 52 KG
- 57 KG
- 63 KG
+ 63 KG
Required
NATIONALITE
*
Nationalité - Nationality - Nationaliteit
Your answer
CLUB
*
Nom du club - Name of the club - Naam van de club
Your answer
COACH
*
Nom du coach - Name of the coach - Naam van de coach
Your answer
ADRESSE MAIL
*
Your answer
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