Register for the LDOM 2017

Complete the form below to take part of the LDOM 2017!


Personal details







Competition details

I'm a individual (€ 10,-)
I'm a team (€ 25,-)


23th September 2017


Yes, I'm in the possession of a fierce colored swimming cap


BBQ

Do you want to take part of the BBQ on 23th September? Fill out the number of people that will take part of the BBQ(including yourself). € 17,50 p.p.


Confirm

I accept the terms of the LDOM 2017
I accept my registration is not definitive until I completed my payment.