Registration form Season 2010-2011
Club Name
Team Name
*
Level (A/B/C)
A
B
C
*
CONTACT INFO
Team Captain
Name
*
Address
Postcode + City
Country
België / Belgique
Nederland
Deutschland
Phone nbr
home
mobile
*
E-mail
*
Contact person2
Name
*
Phone nbr
home
mobile
*
E-mail
*
Name
E-mail address
Player
3
Player
4
Player
5
Player
6
Reserve 1
Reserve 2
Remarks /
other e-mail addresses
for mailing
fields marked with * are mandatory
