APPLICATION FORM 2012

Bringing own food/drinks is NOT allowed on the tournament-site!
Seized goods will be stored at the Information Desk


*Rugbyclub:
*Responsable:
Address:
Country:
Tel.:
Fax:
*Email:
Website:


(*=Denotes obligatory field)



A levy of 250 euro applies to each team participating. The tournament levy should be paid before 15-01-2012 directly into the bank account provided below. The participation will only be finalised once the levy has been paid.


Payable to

Name:Dendermondse Rugbyclub
Address:Koning Albertstraat 140
9200 Dendermonde (Belgium)
Bank name:PNB PARIBAS FORTIS
Bank Address:Fr. Van Schoortstraat 2
9200 Dendermonde (Belgium)
Bank Account:001-1177579-75
Swift Code - BIC CodeGEBABEBB
IBAN-nummer:BE05 0011 1775 7975

INSURANCE: ALL TEAMS MUST ARRANGE THEIR OWN INSURANCE POLICIES!
Please bring the necessary documents with you to Dendermonde.
In case of treatment at the local hospital a copy of the identity card is required.

tarieven