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Registrationform A-Tri part 6
Date: 2018, February 23-25
Location: Vondelchurch Vondelstraat 120 Amsterdam
First name *
Your answer
Surname *
Your answer
Country of residence *
E-mail *
Your answer
€ 160,- (living in the Netherlands)
€ 110,- (not living in the Netherlands)
I will pay *
Remarks (info:
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Payment details
Payments are to be made before 2018 February 15th to account number of Ligmincha Nederland, Oisterwijk.
Please include <name(s) of participant(s)> and <A Tri 2018>

IBAN NL56 INGB 0006 2885 89

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