Inscription 1e Mai 2019 - Dilbeek
!!! This information is required for a valid registration.!!!
Where: domein Castelhof of Dilbeek (Molenstraat 102, 1700 Dilbeek) When: Wednesday 1st of May 2019 09u30 – 17u00
Nom - Naam - Name *
Your answer
Prénom - Voornaam - First name *
Your answer
Adresse - Adres - Adress *
Your answer
Code Postal - Postcode - Zip code *
Your answer
Ville - stad - city *
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Pays - Land - County *
Your answer
GSM *
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E-mail *
Your answer
Date de naissance - geboortedatum - date of birth *
Attention: this event is for youth only ( 15 - 35 years )
MM
/
DD
/
YYYY
Sexe - Geslacht - Sex *
Paroisse - Parochie - Parish *
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