Complete the form below to apply and try to get a degree of the association Club des Cinglés du Mont-Ventoux.
The form is divided into two sections:

  • candidates (up to a maximum of 20);
  • referent.

Applicants will be registered in the database to access the list of graduates and partecipate to the statistics. The referent will be responsible for payment (20 euro per candidate, via secure system Paypal) and will receive notifications by e-mail related to inscriptions and payments. In addition, it will be the intermediary between candidates and association for any communication.

Cart

Candidates
0
Bicinglettes
0
Cinglés
0
Galériens
0
Amount
0.00 €

* Mandatory field

Candidate # 1

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Personal data





Address





Referent

Referent





19 + 1  493A85 
Payment





Validation
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