INSCRIPTION AU CLUB

INSCRIPTION TO THE CLUB - SAISON 2022 / 2023

Fill out the following form to join our club.

Difficulty in filling out the form? Contact us by email at havibruxelles@gmail.com or by phone at 0483 690 277

Last name

First name

Your e-mail address

Your phone number

Date of birth

Do you have a visual disability?

Yes

Nationalité

Address of residence

Postal code

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