*** ENTRY FORM 2012 ***

23th International Tournament of Kayak-Polo

CHARLEROI/SENEFFE - BELGIUM

MAY 5th & 6th, 2012

Please, one team per form

INSCRIPTION FEE = € 100,-

Bungalows or Chambers = € 15,- per night/person with breakfast

Breakfast for Campers (or others) = € 4,- per day/person

Barbecue = € 12,- per person

ATTENTION - ATTENTION - ATTENTION

End of inscription : Maximum teams valided (payment OK) or Dead Date 30/03/2011

Maximum teams : 1st Division=36 - 2nd Division=20 - Dames=8

Obligatory payment on bank account to validate inscription.

Payment before April 10th, 2012

PAYMENT ONLY ON THIS BANK ACCOUNT

BANK ACCOUNT : 260-0008238-62

BANK : BNP FORTIS

IBAN : BE51 2600 0082 3862 - BIC : GEBABEBB

ACCOMODATION AVAILABLE IN BUNGALOWS AND ROOMS

If you have any problem to send this form, please contact me, and send all details in any form of message.

Thanks - Johan

Copyright(c) 2007 Kayak Club Charleroi. Tous droits réservés.