2017 MEMBERSHIP
Civilité / Gender *
Prénom / Name *
Your answer
Nom / Surname *
Your answer
Date de naissance / Birthday *
MM
/
DD
/
YYYY
Adresse / Adress
Uniquement pour les nouveaux membres / only for new members
Your answer
Numéro de télephone portable / Cell phone number *
Your answer
Numero d'urgence / Emergency number *
Your answer
Email *
Your answer
Marque/Modèle VTT Bike brand
Your answer
Commentaires / Any Comment ?
Your answer
Taille T-shirt / T-shirt size *
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