Registration Date: / / 2022
I hereby register for
Course / activity / trip:
Course or class day, place and time:
First and last name:
Telephone at home:
Date of birth: time of birth:
I want to receive the digital newsletter: Y / N
I have / have not followed a previous course. Which?
When registering, you sign for participation and agree to the registration and payment conditions (see below).
Sign this form and send it to Ed Dirker
mail to email@example.com