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Inscription - Nouvelle demande
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Prénom du licencié(e)
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Nom du licencié(e)
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Genre
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Masculin
Féminin
Date de naissance
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MM
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DD
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YYYY
Lieu de naissance (code postal - ville - pays)
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Email
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Téléphone
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Prénom du responsable légal (si licencié mineur)
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Nom du responsable légal (si licencié mineur)
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