BOOKING FORM 

Please print and fill in the form below for each participant. 
Please send by postal delivery accompanied by the pre-payment cheque for course training. :
  

      

Booking form to turn over to:
regisgerard.com
B.P. 55
10403 NOGENT-SUR-SEINE CEDEX France

     

Before carrying out your reservation, 
phone to (33) 3.25.39.01.91. 
in order to know the availabilities.

   
  
NAME FIRST NAME
ADDRESS
CITY CP
DATE OF BIRTH PHONE
ADDRESS E.mail
  

TRAINING COURSE Nbr of participants Nbr of days From the ................. to the .................

TEENAGER TRAINING COURSES 7 DAYS 7 TECHNIQUES From the ................. to the .................

TEENAGER TRAINING COURSES IMPROVEMENT 4 DAYS From the ................. to the .................

INDIVIDUAL Nbr of days From the ................. to the .................

FISHING IN YOUR AREA From the ................. to the .................

OTHER From the ................. to the .................
  
Price ...................... euros ACCOUNT :  .... 200 euros BALANCE ........................ euros

Read and approved (handwritten mention) 

 

Date and signature

 

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