APPLICATION FORM 2010

*Rugby Club:
*Contact Person:
Address:
Country:
Tel.:
Fax:
*Email:
Website:
Division:

(*=Denotes obligatory field)


Confirms his participation to the 17th Flanders Open Rugby Tens of 2010, May 22th & 23th.

Bringing your own food/drinks is NOT ALLOWED on the tournament-site!

The registration fee 250 euro must be paid before 15-01-2010. 125 euro will be paid back in the form of consumptiontickets.

Payable to

Name:Dendermondse Rugbyclub
Address:Koning Albertstraat 140
9200 Dendermonde (Belgium)
Bank name:FORTIS Bank
Bank address:Fr. Van Schoortstraat 2
9200 Dendermonde (Belgium)
Bank Account:001-1177579-75
Swift Code:CGAKBEBB 001-1177579-75
BIC Code:GEBABEBB
IBAN-nummer:BE 05001117757975

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.