Registration form

[Nederlandse versie]Social Inclusion Games 2010, 1 to 7 August

* These fields are required!

Organisation *

Address *

Zipcode *

City *

Country *

Phonenumber *

Website

Total participants *

Main contact person (contact during the games)

First name *

Last name *

Mobile phone *

E-mail *

 Emergency Response Officer

Contact details other supervisor(s) (minimal of 1 supervisor per 10 participants)
Supervisor 1

First name

Last name

Mobile phone

E-mail

 Emergency Response Officer

Supervisor 2

First name

Last name

Mobile phone

E-mail

 Emergency Response Officer

Supervisor 3

First name

Last name

Mobile phone

E-mail

 Emergency Response Officer

Supervisor 4

First name

Last name

Mobile phone

E-mail

 Emergency Response Officer

Provide number of participants per team* and also mark the activity*

Competitive activity
 Street Football
 Field Football
 Pétanque
 Archery
 Beach Volleyball
 Floor Ball
 Badminton
 Table Tennis
 Athletics
 Cycling
 Basketball
 Tennis
 Swimming
 Bowls
 Soft Ball
 Knotsbal
 Indoor Volleybal
 Climbing

Recreative activity
 Darts
 Billiards
 Checkers
 Chess
 Backgammon

Verification code *
captcha

I agree with the Guidelines for taking part in the Games *

* These fields are required!

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