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Madame
Monsieur
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52 km ( vélo course ou VTT)
30 km ( VTT )
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S
M
L
XL
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OUI
NON (envoyer le certificat médical sur mél: bds.dlem.mayotte@gmail.com)
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Oui
Non
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Civilité
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Nom
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Prénom
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Date de naissances
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Adresse mail
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Affectation (ex.:DLEM, BSMA, PAF, RENAULT, POLICE NATIONALE...)
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Circuit
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Taille de Tee-shirt
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Possession d'une licence FCD (CSA DLEM)
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Participation au repas du DLLEM à 12h30(gratuit)
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