The stables of the parpaillots

REGISTRATION FORM  

2020/2021

Attachments :

• competition license application:

• Medical certificate :

Registration date  :

License number 2019  :                                            gallop level  :

Last name :                                                    First name :

Date of Birth  :                                       Age  :

Address :

City :                                                             Postal code :

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Phone. Residence :                                     Phone. Office :

Phone. Portable :                                      E-mail :

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Occupation: father:

Occupation: mother:

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Person to notify in case of emergency  :

(Essential)

Phone :

Image rights authorization

I, the undersigned, (surname, first name, date of birth and address):

__________________________________________________________________________________

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Father/mother/guardian  of child(ren):

  __________________________________________________________________________________

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Authorizes the Ecuries des Parpaillots club and the association of friends of the parpaillots  to use any photos and/or videos taken during the activities and events of the equestrian center.

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Done at ________________________, On ____________________

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Signature

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Part to be completed carefully  

Reasons and amounts: Possibility of paying in 8 instalments for annual subscriptions.  

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Settlement Dates:-1°:                        //-2°:                           //- 3°:                                 //- 4°  :                      //-5°:                        //-  6°:                        //-7°:

//-8°:

Mode of payment : check:            ; species:                     ; holiday vouchers :   ; 

Membership  :         35     €

Licence  :   - 18 years old: 25     €      + 18 years old: 36€ ( cross out the useless mention )

Chosen subscription : Quarterly 1 lesson per week valid for 1 quarter: €160

                    Quarterly 2 lessons per week valid for 1 quarter: €240

                    Annual 1 lesson per week without school holidays  (32 lessons): 450€

                    Annual 2 lessons per week without school holidays (64 lessons): €810

                    Annual 1 class per week (52 classes): €605

                    Annual 2 lessons per week (104 lessons  ): 950€ 

Family advantage (on subscriptions only): second registration: -5%, third registration: -10% 

fourth registration: 15%

Cross out unnecessary mentions, thank you 

NOTES:

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Course chosen : day:                                      time :

               day :                                        time :  

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