Pictures Events Courses Registration Confirmation Results
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August 5th, 2012

Fill out entry form, print and send by mail

Traversée 1km individual $30
Traversée 2km individual $30
Traversée 5km individual $30
Last Name:
First Name:
Address:
City:
Province :
Postal Code:
  
Country :
Phone:
 ( ) - -
Email:
Birthday :
Year   Month   Day
Age on the day of the event:

  years
Sex :
 Man
Woman
# FNQ :
Fédération :
Credit card
(Visa and Mastercard):
 - - -   Exp:  /  (MM/YY)
+ Fees 5$ Visa and Mastercard
Total:
  
  • Option 1:
    Send by fax with Visa or Mastercard # to (450) 227-3578
    (add 5$ to entry)
  • Option 2:
    Send by mail with cheque to:
    SporTriple 1139, chemin de la Paix Saint-Sauveur Qc. JOR 1R2
  • NO POSTDATED CHECKS.

 
 

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