prijavnica / entry form ptl2016

Prijavnica / entry form paddle the lake 2016

* Indicates required field

Ime in priimek / Name and Surname *

First

Last

telefon / mobile *

el. naslov / Email *

ulica / street *

številka / number *

mesto / city *

pošta / postal code *

država / country *

CLASS *

klub / club *

rojstni datum / date of birth *

spol / gender *

velikost majice / t-shirt size *

prijava je veljavna s plačilom štartnine / registration is valid with the payment of the entry fee

ŠD ZOO STATION VELENJE
Gubčeva 11
3320 Velenje

SI56 1010 0005 4629 716 (banka koper)
Referenca: 00 0003
namen: ime in priimek

pošlji / send