Galop.be Equine Registration System (ERS)
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Personal data
Give here your personal data. This data will be used when you subscribe for a competition
Firstname rider : * Lastname rider : *
Address : * Postal code : *
Location : * Country : *
Telephone : Mobile :
Fax : E-mail : *
E-mail (again the same email address): *    
Born : * / / Nationality : *
Sexe : * Language : *
Account number : Bank :
Iban number : BIC/SWIFT :

(*) Mandatory fields

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