Cyprus
WIFSA2014@gmail.com

Membership Application Form - Bulletin d'inscription

Club Name:
  President:
Individual Name:
  Gender:  Male  Female   Age:  
Address:
City:
  State:   Postal Code:
Country:
Phone:
  Email:
List of Club Skaters
Name 1:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 2:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 3:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 4:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 5:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 6:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 7:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 8:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 9:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 10:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 11:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 12:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 13:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 14:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 15:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 16:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 17:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 18:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 19:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Name 20:
  Gender:  Male  Female   Date of Birth:  
Registered in a WIFSA Club:Yes  No   If no, please provide email: 
Fee:
Type



 

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