| | 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 | | | |