Inscription benevole / Volunteer registration
Prénom / First name: *
Your answer
Nom / Last name: *
Your answer
Date de naissance / Birthday: *
MM
/
DD
/
YYYY
Genre / Gender:
Adresse (rue, no., apt.) / Address (street, no., apt.) : *
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Commune / City: *
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Code postal / Postal code: *
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Tel 1: *
Your answer
Tel 2:
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Email: *
Your answer
Contact en cas d'urgence - nom / Emergency contact - name: *
Your answer
Tel. no: *
Your answer
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