Souches 2020 - INSCRIPTION \ REGISTRATION
Email address *
Nom / Last name *
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Prénom / First name *
Your answer
Catégorie de participant *
Date de naissance / Date of birth *
MM
/
DD
/
YYYY
Adresse civique *
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Ville *
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Code postal *
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Téléphone (999) 999-9999 *
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Personne à rejoindre en cas d'urgence / In case of emergency, contact this person: *
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Téléphone en cas d'urgence (jour et soir) / Emergency contact phone number *
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