Inscription 20km de Bruxelles 2019 Inschrijving 20km door Brussel 2019 Registration 20km of Brussels 2019
First name (prénom - voornaam) *
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Name (nom de famille - familienaam) *
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Email *
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Sex *
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Date of Birth *
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YYYY
Nationality *
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Street, nummer *
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Postal Code *
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City *
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Mobile *
ex: +324000000
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If you run with your company : name of the company
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Chrono 20km 2018 or reference time on 20km *
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Race Number 2018/Chronocode
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I declare hereby to be in good physical condition. *
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Chaîne de l'Espoir Belgique - Keten van Hoop België accepts no responsibility for any damage that may occur to participants in 20km of Brussels *
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I commit to participating to the sponsorship action and to collect a minimum amount of 30€ *
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Size for the Tshirt *
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Thank you for your registration! Dank U voor uw inschrijving! Merci pour votre inscription!
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