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Solicitud de ingreso al Círculo Social Longchamps
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Correo electrónico
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Apellido y nombres
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Número de DNI
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Fecha de nacimiento
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MM
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DD
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Nro. de celular
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Edad
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Domicilio
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Localidad
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Seleccione Actividad
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NINGUNA (SÓLO ASOCIARME)
ACROBACIA AEREA - TELAS
BAILA TODO - SALSA - BACHATA
BASQUET
BOXEO
CAPOEIRA
COSTURA
CROCHET
DANZA JAZZ
ENTRENAMIENTO FUNCIONAL
FITNESS DANCE
DANZAS FOLKLORICAS
DANZAS URBANAS
FUTBOL
GIMNASIO
KARATE
KUNG FU
KICK BOXING
PATIN
PSICOLOGIA
SIPALKI
TAEKWONDO
TAICHI
VOLEY
YOGA
OTRAS
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