Inscription en ligne

Formulaire d'inscription

{"field_91d8eb2":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_32951b5":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_26080dd":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_a7cb025":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_bd8a0a3":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_2de1977":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_08fe9e7":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_1f80fd2":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_eb7803f":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_74bdf72":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_0a495b7":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]},"field_68273fe":{"display_mode":"show","fire_action":"All","logic_data":[{"cfef_logic_field_id":"field_df3dc5a","cfef_logic_field_is":"==","cfef_logic_compare_value":"OUI","_id":"919e7b1"}]}}

Nom

Prénom

Date de naissance

Sexe

Adresse

Code Postal

Ville

Téléphone

E-mail Licencié

Licence France Judo

Ceinture

Autorisation de diffusion d'image

OUI NON

Cértificat médical ( Si besoin )

Licencié Mineur

OUI NON

Nom mère

Nom père

Profession mère

Profession père

Tél mère

Tél père

E-mail mère

E-mail père

Personne autorisées à venir chercher votre enfant

Nom, Prénom

Téléphone

Lien avec votre enfant

Dojo olympic