Inscriptions AQUA GYM 2017/2018
Date du jour (JJ/MM/AAAA)12/06/2017 *
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Êtes vous ancien ou nouvel adhérent ?
Nom *
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Prenom *
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Date de naissance (JJ/MM/AAAA) *
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Adresse *
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Code postal *
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Ville *
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Fixe
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Portable *
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Email *
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Merci de bien vouloir confirmer votre email *
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