Nom 2021 Registration form To be sent back with your payment by credit card. Océan Paddlecamp - 9, rue de l’Atlantique - 29160 CROZON / MORGAT - Tél.: 06 61 92 64 35 First name * Phone Email * Last name * Date of birth Facebook name Your adress Important Sports license* Or medical certificate of less than 3 months of no contraindication to the practice Stand Up Paddle, outrigger, Prone Paddle. Possibility to submit the medical certificate directly to us. * The sports license is not necessary for the Yoga course. Attach your medical certificate Licence number CAMP PERIOD Sports federation Choose your course * Your Course Les journées techniques - préparation physique Week-end down-wind et training - N1 Week-end down-wind et training - N2 Semaine down-wind et training - N2 Tarifa - Andalousie - Espagne Week-end foil Quatre jours Yoga et océan Week-end Paddle vin et châteaux ADDITIONAL INFORMATION Praticted sports Practiced support SUP Outrigger Prone Paddle Other : Other sports practiced Ocean experience Other practiced support Board used(Brand/model/width size) Number of sports sessions per week Health information Health problems or allergies : Image authorization Autorisations I authorize Océan Paddlecamp to publish the photos and / or videos taken of myself during this activity. I respect the COVID19 protective precautions as best as possible and I disclaim all responsibility of Océan Paddlecamp in the event of contamination by the virus. I have read and accept the Ocean Paddle Camp rules of procedure Date * At * Sign * Océan Pirogue, 9 rue de l’atlantique 29160 CROZON www.oceanpaddlecamp.com SIRET 505 109 19900033 - N° Jeunesse et sports : 02909ET0071
