| BRIARE PETANQUE | |
| | | | | | | | | | | |
| Nom: | | | | Prénom: | | | | | |
| | | | | | | | | | | |
| N° Licence | | | | | | | | | | |
| | | | Tête à Tête | | | Homme | | | | |
| Comité | | | | | | | | | | |
| | | | Doublette | | | Femme | | Promotion | | |
| Ligue | | | | | | | | | | |
| | | | Triplette | | | Mixte | | | | |
| | | | | | | | | | | |
| Date: | | | Lieu: | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| Résultat | | | | | | | | | | |
| | | | | | | | | | | |
| Cachet et nom de la personne qui valide ce document | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| Document à remettre avec la demande de participation financière de Briare Pétanque | | | |
| | | | | | | | | | | |
| BRIARE PETANQUE | |
| | | | | | | | | | | |
| Nom: | | | | Prénom: | | | | | |
| | | | | | | | | | | |
| N° Licence | | | | | | | | | | |
| | | | Tête à Tête | | | Homme | | | | |
| Comité | | | | | | | | | | |
| | | | Doublette | | | Femme | | Promotion | | |
| Ligue | | | | | | | | | | |
| | | | Triplette | | | Mixte | | | | |
| | | | | | | | | | | |
| Date: | | | Lieu: | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| Résultat | | | | | | | | | | |
| | | | | | | | | | | |
| Cachet et nom de la personne qui valide ce document | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| | | | | | | | | | | |
| Document à remettre avec la demande de participation financière de Briare Pétanque | | | |