Registration Kino Kabaret Poissonnerie 2018
Email address *
Nom / Surname *
First Name / Prénom *
Adress /Adresse *
Zip Code / Code Postal *
City / Ville *
Country / Pays *
Email *
Mobile Phone Number / Numéro GSM *
Have you been involved in KinoKabaret before? / Avez vous déjà participé à un Kinokabaret *
Are you member of a KinoKabaret cell? / Etes vous membre d'une cellule Kino *
I'd like to participate to the following session(s): / Je souhaite participer aux sessions suivantes *
Required
I'd like to participate as: / Je participe en tant que *
Required
Date of arrival / Date d'arrivée *
MM
/
DD
/
YYYY
Accomodation / Logement *
Food Restriction and Allergies / Allergies et régimes spéciaux *
I am a minor / Je suis mineur *
Questions & Suggestions
A copy of your responses will be emailed to the address you provided.
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