Parental authorization


Parental authorization

(compulsory for minors)

By checking this box, I digitally sign (Name*) (First name*) , resident (adress*) (additional address) , (ZIP code) (town*) , acting as father, mother or legal guardian, authorizes the minor (Name*) (First name*) , born* the , to participate in the Rallye du Canal du Midi and planned activities that will take place from 10 to 15.8.2015.

Name and First Name of the person who will look after the minor during the event :
(Name*) (First Name*)

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