Le Treg

As a

CIVIL STATUS

Civility

First name

Last name

Address

Postal code

Town

Country

Mobile

Phone

Age

Date of birth

Place of birth

Marital status

Occupation

Passport N°

Nationality

Issue date

Authority

Expiration date

FURTHER INFORMATION

Office phone number

Weight

Height

Clothes size

Have you ever used an outdoor GPS ?
Yes No

Skill level
Good Medium Novice

Your race achievement goals

Departure from

Registration

BILLING

Sponsoring runner

Team

Invoice made out to

IN CASE OF EMERGENCY

Person to reach

Relationship

Address

Mobile

Phone

I certify that the above information is correct

I agree to read the general conditions of sale and the confidentiality policy available on the site www.le-treg.com before formalizing my final registration