Registration

REGISTRATION ON LINE

NAME OF CLUB :
*
ADRESS :
*
ZIP Code :
*
TOWN :
*
CLUB e-mail :
*
FULL NAME delegations' persons in charge :
*
Mobil phone number :
*
e-mail :
*
TEAM ENTRY :





 
DELEGATION NUMBER OF PERSONS :
*
ACCOMPANYING PERSONS Nber less 5 years :
*
ACCOMPANYING PERSONS Nber from 5 to 12 Years :
*
ACCOMPANYING PERSONS Nber more than 12 :
*
ARRIVAL :


 
* Champ obligatoire
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Payment

Completed file and payment to be sent to:

 

COMITE DEPARTEMENTAL DE BASKETBALL des P.O

Maison des Sports

Rue Duguay Trouin

66000 PERPIGNAN

France

 

IF APPLYING ONLINE , ONLY (BANK–TRANSFER) PAYMENT IS TO BE MADE BEFORE MARCH 15, 2015


You can either :


Pay the total price when Entering, before March 15, 2015,

by Bank Transfer References as follows:

 

IBAN = FR76 1660 7000 1901 9192 2052 974

BIC= CCBPFRPPPPG

 

Or, when entering, make only a bank transfer down-payment amounting to at least 30% of the total due, and pay up the balance before March 15
(Bank transfer again)

Entry will be confirmed as soon as you payment has been received
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Team composition


Repeat a Form for each team competing
Nom du CLUB :
*
CATEGORY :





 
Coach (Full name) :
 
E-mail :
 
Mobil phone number :
 
Number+ FULL NAME PLAYERS :
*
* Champ obligatoire
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Contact sheet

If you would like further information, feel free to contact us by leaving your application on this page.
We will respond to the email address you have given us.

Best Regards
Marc REBOUL
TDR organization responsible
+33612215870
.
.
.
Nom du club :
*
Nom et Prénom - Full name :
*
Adresse mail :
*
Votre message - Your message :
 
* Champ obligatoire
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