1 Dear sport friends, As every year, we organise the International

1 Dear sport friends, As every year, we organise the International

Dear sport friends,
As every year, we organise the International Tournament of Pas-de-Calais of Canoe Polo on April 23rd
and 24th 2016.
This 17th edition will be organised in the city of Saint-Omer (north of France). You will find the entry
form and information about meals and accommodations (free camping).
Best regards,
Philippe LALLIOT
President of Saint-Omer club and CDCK 62
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This form is to be fulfil before 3rd April 2016 !
CONTACT DETAILS
Team name
Team leader
Address
Post Code
City
Country
Email
Phone
CATEGORY & REGISTRATION FEES
☐
Division 1 (12 teams maxi)
80 € per team
☐
Division 2 (18 teams maxi)
80 € per team
☐
Division U18 + Dames
80 € per team
☐
U16
40 € per team
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CATERING RATES
“A la carte” prices
Number of people
Saturday breakfast
Unit price
TOTAL
4,5 €
Saturday lunch
8€
Saturday dinner
12 €
Sunday breakfast
4,5 €
Sunday lunch
6,5 €
TOTAL
“All inclusive” formula
All meals
30 €
Club name
Number
SURNAME
NAME
Birth date
License Number
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SURNAME
Camping : ☐YES
NAME
QUALIFICATIONS
☐NO
Estimated arrival hour : ............................................................................................................................
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Division 1
Division 2
Dames
Winner
150 €
Finalist
100 €
3rd place
50 €
Winner
100 €
Finalist
70 €
3rd place
40 €
Winner
100 €
Finalist
70 €
3rd place
40 €
Registrations will be definitely taken into account on receiving of the regulation.
Bank : CL Saint-Omer (06034)
Name of account holder : CDCK 62
IBAN : FR63 3000 2060 3400 0011 7029 A71
BIC : CRLYFRPP
Please intitulate the bank transfert as follow : TIP2016 + Team Name + Division
Email : [email protected]
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