Note: Ce
formulaire n'est pas utilisé |
Ligue Interrégionale AA/BB 2003 |
| Divisions | Gérant | Assistant No 1 |
| Atome | Nom: _______________________________________________ Prénom: _____________________________________________ Adresse: ____________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
| Moust. | Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Nom: ______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
| Peewee | Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
| Bantam | Nom: ______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Nom: ______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
| Midget | Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Nom: _______________________________________________ Prénom: ____________________________________________ Adresse: ___________________________________________ Ville: _____________________________ CP ____________ Tél: _______________________ Ent. Niveau: ______ |
Signature Gouverneur: ___________________________________________________________
Date: _________________