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Private Training - Entrainement Privé
Inscription - Registration
Nom *
Name
Your answer
Prénom *
First name
Your answer
Sexe *
Gender
DDN - DOB *
12/05/2014
MM
/
DD
/
YYYY
Adresse *
Address
Your answer
Code Postal *
Postal Code
Your answer
Ville *
City
Required
Arrondissement *
Borough
Your answer
Tel *
Your answer
Your answer
RAMQ *
DIGJ 2105 1411 EXP 2015 05
Your answer
Maladies ou Allergies ? *
Illnesses or Allergies?
Your answer
Épipen ou autres Médicaments? *
Medications or Epipen?
Your answer
Avezvous déjà fait d'autres sports ou arts martiaux? *
Have you done other sports?
Required
Objectif de l'entrainement *
Purpose of the training
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Quel est votre budget? Tarif présentement 40$/ Session = 1h *
What is your budget? Going rate 40$/ Session = 1h
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Quelles sont vos disponibilités? (plus de 1 réponse acceptée) *
What are you availabilities? (more that1 answer can be submitted)
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