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Start the Virtual Tour

Course Registration Form

Date of birth
Month
Day
Year

REQUESTS REGISTRATION AS AN ATHLETE AT THE POLISPORTIVA GONZAGA SSD a RL

Single choice
For himself/herself
as the person exercising parental responsibility for the minor

Athlete's Personal Data

Sports Activity Requested
Select Coach
Gonzaga Student
YES
NO
School Address
Pagata
Si
No

Verrà pagata subito dopo che il modulo e stato firmato e inviato.

PAYMENT PLAN

Payment Plan
One Solution
In monthly installments

Single Payment Plan

Pagato
SI
No

E possibile pagare la quota alla conclusione del modulo o in un secondo momento. Selezionare Si, se desidera effetuare il pagamento alla conclusione del modulo, selezionare No se desidera pagare in un secondo momento.

Monthly Payment Plan

Signature Affixing

PR Authorizations
Authorize
Does not authorize
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Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

LCS Palermo

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