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Name* First name *

Adress*

Country*

Tel number* Fax  Email*

A password if you want to modify your file *

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Glider : brand  * / type / colour

Special peculiarities on your glider    

Social security number    blood group   

Allergies and medical peculiarities  :

Person to be called in case of accident  :

Will you have a mobile during the competition ? #

G.P.S. model ?

Would you like to be a candidate to the pilots committee ? YES / NO

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Press information :

your sports classifications:

your best results in competition :

your PWC national ranking this year :

Payment : your registration will be effective as soon as we receive your payment.
- You’ll be charged 100€ if you pay before June 30, 2007 
- You’ll be charged 120€ if you pay between July 1 and September 30, 2007 
- You’ll be charged 140€ if you pay after September 30, 2007 

•  Send a cheque payable to LVLR to: CROCVL José Chapelet, 34bis rue Paille en Queue, 97434 La Saline les Bains / La Réunion
• Or make a bank transfer to : Ligue de Vol Libre de la Réunion at Caisse d’Epargne,

IBAN : FR76 1131 5000 0104 3193 0198 375 – BIC : CEPAFRPP131