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Subscription form

Id Empresa

293

Welcome to the club

REVOLUTION SANT CUGAT

Student Data
Tutor
Sports data
Training days
Pickup Service
Economic Data
Acceptance conditions
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Name

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Date of Birth

Gender

MASCULINO FEMENINO OTROS

D.N.I./RUT

Health card

Phone

E-mail

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Province

Town/Municipate

Address

Postal code

Do you have any immediate family members enrolled in school?

Name tutor/a 1

Tutor’s name 2

Telephone tutor 1

Telephone Tutor 2

Email Tutor 1

Email Tutor 2

Dni

Medical Data

Discipline

Cuota Actividad

H M

Sí No

H T

Sí No

H W

Sí No

H T

Sí No

H F

Sí No

H S

Sí No

H S

Sí No

Pick-up Service

R M

R T

R W

R T

R F

R S

R S

Pick-up point

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Account holder

Conditions Club

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Authorize Commercial Shipments

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