Probleme d'envoie du Formulaire

Bonjour,

Voici mon codage je souhaite juste puvoir m'envoyer tous se formulaire mais il semble qu'il y aurait un plrobleme de codage quelqu'un peut s'il vous plait?

voici le rendu du formulaire dans incription login duprel passe hzqysfow : https://www.sfr.fr/fermeture-des-pages-perso.html
voici mon codage :

<FORM method="get" action="MAILTO:mon adresse" <><TBODY><TR><TD> 
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN> </P>
<P style="TEXT-ALIGN: center; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 16pt"><FONT color=#be6aec></FONT></SPAN></B></P>
<P style="TEXT-ALIGN: center; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 16pt">D2G07</SPAN></B><B style="mso-bidi-font-weight: normal"><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 14pt"> / DAUPHINS DE GUILHERAND GRANGES 07</SPAN></B></P>
<P style="TEXT-ALIGN: center; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Piscine Iris - 20 Quai du Rhône<SPAN style="mso-spacerun: yes"> </SPAN>- 07500 GUILHERAND GRANGES</SPAN></B></P>
<P style="TEXT-ALIGN: center; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Tél : 06 70 02 11 97<SPAN style="mso-spacerun: yes"> </SPAN>Mail : dauphins-guilherandgranges07@laposte.net</SPAN></B></P>
<DIV class=Section1 align=center>
<TABLE style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium none; mso-border-alt: solid black .5pt; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black" class=MsoNormalTable border=1 cellSpacing=0 cellPadding=0 align=center>
<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: black 1pt solid; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 530.3pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: black 1pt solid; BORDER-RIGHT: black 1pt solid; PADDING-TOP: 0cm; mso-border-alt: solid black .5pt" vAlign=top width=884 colSpan=2>
<P style="TEXT-ALIGN: center; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">BULLETIN D'INSCIPTION SAISON 2010-2011</SPAN></B></P></TD></TR>
<TR style="mso-yfti-irow: 1">
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: medium none; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 530.3pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: medium none; PADDING-TOP: 0cm; mso-border-top-alt: solid black .5pt; mso-border-bottom-alt: solid black .5pt" vAlign=top width=884 colSpan=2>
<P style="TEXT-ALIGN: center; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN> </P></TD></TR>
<TR style="mso-yfti-irow: 2">
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: black 1pt solid; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 189.7pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: black 1pt solid; PADDING-TOP: 0cm; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt" vAlign=top width=316>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Type d'Inscription :</SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Première<SPAN style="mso-spacerun: yes"> <INPUT value=M type=radio name=sexe><FONT face=Arial> </FONT><BR></SPAN></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Renouvellement<SPAN style="mso-spacerun: yes"> <INPUT value=M type=radio name=sexe><FONT face=Arial> </FONT><BR></SPAN></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Transfert<SPAN style="mso-spacerun: yes"> <INPUT value=M CHECKED type=radio name=sexe><FONT face=Arial> </FONT><BR></SPAN></SPAN></P></TD>
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: medium none; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 340.6pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: black 1pt solid; PADDING-TOP: 0cm; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; mso-border-left-alt: solid black .5pt" vAlign=top rowSpan=2 width=568>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><B style="mso-bidi-font-weight: normal"><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Informations Adhérents :</SPAN></U></B></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN> </P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Nom :<INPUT name=prenom> Prénom : <INPUT name=prenom> </SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Adresse : <INPUT style="WIDTH: 500px; HEIGHT: 25px" size=45 name=prenom></SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Code Postal : <INPUT style="WIDTH: 143px; HEIGHT: 25px" size=12 name=prenom><SPAN style="mso-spacerun: yes"> </SPAN>Ville : <INPUT style="WIDTH: 239px; HEIGHT: 25px" size=23 name=prenom></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Date de naissance :<SELECT style="WIDTH: 44px" name=fonction> <OPTION value=""></OPTION><OPTION value=1>1</OPTION> <OPTION value=2>2</OPTION> <OPTION value=3>3</OPTION> <OPTION value=4>4</OPTION> <OPTION value=5>5</OPTION> <OPTION value=6>6</OPTION> <OPTION value=7>7</OPTION> <OPTION value=8>8</OPTION> <OPTION value=9>9</OPTION> <OPTION value=10>10</OPTION> <OPTION value=11>11</OPTION> <OPTION value=12>12</OPTION> <OPTION value=13>13</OPTION> <OPTION value=14>14</OPTION> <OPTION value=15>15</OPTION> <OPTION value=16>16</OPTION> <OPTION value=17>17</OPTION> <OPTION selected value=18>18</OPTION> <OPTION value=19>19</OPTION> <OPTION value=20>20</OPTION> <OPTION value=21>21</OPTION> <OPTION value=22>22</OPTION> <OPTION value=23>23</OPTION> <OPTION value=24>24</OPTION> <OPTION value=25>25</OPTION> <OPTION value=26>26</OPTION> <OPTION value=27>27</OPTION> <OPTION value=28>28</OPTION> <OPTION value=29>29</OPTION> <OPTION value=30>30</OPTION> <OPTION value=31>31</OPTION></SELECT><SELECT style="WIDTH: 83px" name=fonction><OPTION value=""></OPTION><OPTION value=janvier>janvier</OPTION><OPTION value=fevrier>février</OPTION><OPTION value=mars>mars</OPTION><OPTION value=avril>avril</OPTION><OPTION value=mai>mai</OPTION><OPTION value=juin>juin</OPTION><OPTION selected value=juillet>juillet</OPTION><OPTION value=aout>août</OPTION><OPTION value=septembre>septembre</OPTION><OPTION value=octobre>octobre</OPTION><OPTION value=novembre>novembre</OPTION><OPTION value=decembre>décembre</OPTION></SELECT><SELECT style="WIDTH: 73px" name=fonction><OPTION value=""></OPTION><OPTION value=1910>1910</OPTION> <OPTION value=1911>1911</OPTION> <OPTION value=1912>1912</OPTION> <OPTION value=1913>1913</OPTION> <OPTION value=1914>1914</OPTION> <OPTION value=1915>1915</OPTION> <OPTION value=1916>1916</OPTION> <OPTION selected value=1917>1917</OPTION> <OPTION value=1918>1918</OPTION> <OPTION value=1919>1919</OPTION> <OPTION value=1920>1920</OPTION> <OPTION value=1921>1921</OPTION> <OPTION value=1922>1922</OPTION> <OPTION value=1923>1923</OPTION> <OPTION value=1924>1924</OPTION> <OPTION value=1925>1925</OPTION> <OPTION value=1926>1926</OPTION> <OPTION value=1927>1927</OPTION> <OPTION value=1928>1928</OPTION> <OPTION value=1929>1929</OPTION> <OPTION value=1930>1930</OPTION> <OPTION value=1931>1931</OPTION> <OPTION value=1932>1932</OPTION> <OPTION value=1933>1933</OPTION> <OPTION value=1934>1934</OPTION> <OPTION value=1935>1935</OPTION> <OPTION value=1936>1936</OPTION> <OPTION value=1937>1937</OPTION> <OPTION value=1938>1938</OPTION> <OPTION value=1939>1939</OPTION> <OPTION value=1940>1940</OPTION> <OPTION value=1941>1941</OPTION> <OPTION value=1942>1942</OPTION> <OPTION value=1943>1943</OPTION> <OPTION value=1944>1944</OPTION> <OPTION value=1945>1945</OPTION> <OPTION value=1946>1946</OPTION> <OPTION value=1947>1947</OPTION> <OPTION value=1948>1948</OPTION> <OPTION value=1949>1949</OPTION> <OPTION value=1950>1950</OPTION> <OPTION value=1951>1951</OPTION> <OPTION value=1952>1952</OPTION> <OPTION value=1953>1953</OPTION> <OPTION value=1954>1954</OPTION> <OPTION value=1955>1955</OPTION> <OPTION value=1956>1956</OPTION> <OPTION value=1957>1957</OPTION> <OPTION value=1958>1958</OPTION> <OPTION value=1959>1959</OPTION> <OPTION value=1960>1960</OPTION> <OPTION value=1961>1961</OPTION> <OPTION value=1962>1962</OPTION> <OPTION value=1963>1963</OPTION> <OPTION value=1964>1964</OPTION> <OPTION value=1965>1965</OPTION> <OPTION value=1966>1966</OPTION> <OPTION value=1967>1967</OPTION> <OPTION value=1968>1968</OPTION> <OPTION value=1969>1969</OPTION> <OPTION value=1970>1970</OPTION> <OPTION value=1971>1971</OPTION> <OPTION value=1972>1972</OPTION> <OPTION value=1973>1973</OPTION> <OPTION value=1974>1974</OPTION> <OPTION value=1975>1975</OPTION> <OPTION value=1976>1976</OPTION> <OPTION value=1977>1977</OPTION> <OPTION value=1978>1978</OPTION> <OPTION value=1979>1979</OPTION> <OPTION value=1980>1980</OPTION> <OPTION value=1981>1981</OPTION> <OPTION value=1982>1982</OPTION> <OPTION value=1983>1983</OPTION> <OPTION value=1984>1984</OPTION> <OPTION value=1985>1985</OPTION> <OPTION value=1986>1986</OPTION> <OPTION value=1987>1987</OPTION> <OPTION value=1988>1988</OPTION> <OPTION value=1989>1989</OPTION> <OPTION value=1990>1990</OPTION> <OPTION value=1991>1991</OPTION> <OPTION value=1992>1992</OPTION> <OPTION value=1993>1993</OPTION> <OPTION value=1994>1994</OPTION> <OPTION value=1995>1995</OPTION> <OPTION value=1996>1996</OPTION> <OPTION value=1997>1997</OPTION> <OPTION value=1998>1998</OPTION> <OPTION value=1999>1999</OPTION> <OPTION value=2000>2000</OPTION> <OPTION value=2001>2001</OPTION> <OPTION value=2002>2002</OPTION> <OPTION value=2003>2003</OPTION> <OPTION value=2004>2004</OPTION> <OPTION value=2005>2005</OPTION> <OPTION value=2006>2006</OPTION> <OPTION value=2007>2007</OPTION> <OPTION value=2008>2008</OPTION> <OPTION value=2009>2009</OPTION> <OPTION value=2010>2010</OPTION> <OPTION value=2011>2011</OPTION> <OPTION value=2012>2012</OPTION> <OPTION value=2013>2013</OPTION> <OPTION value=2014>2014</OPTION> <OPTION value=2015>2015</OPTION> <OPTION value=2016>2016</OPTION> <OPTION value=2017>2017</OPTION> <OPTION value=2018>2018</OPTION> <OPTION value=2019>2019</OPTION> <OPTION value=2020>2020</OPTION> <OPTION value=2021>2021</OPTION> <OPTION value=2022>2022</OPTION> <OPTION value=2023>2023</OPTION> <OPTION value=2024>2024</OPTION> <OPTION value=2025>2025</OPTION> <OPTION value=2026>2026</OPTION> <OPTION value=2027>2027</OPTION> <OPTION value=2028>2028</OPTION> <OPTION value=2029>2029</OPTION> <OPTION value=2030>2030</OPTION></SELECT>sexe M<INPUT value=M type=radio name=sexes>/  F<INPUT value=M CHECKED type=radio name=sexes></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Nationalité: <INPUT style="WIDTH: 233px; HEIGHT: 25px" size=22 name=prenom></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Tel : <INPUT name=prenom>  Port : <INPUT name=prenom></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Travail <SPAN class=SpellE>sté </SPAN>: <INPUT name=prenom> Tel : <INPUT name=prenom></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">N° en cas d'urgence : <INPUT style="WIDTH: 213px; HEIGHT: 25px" name=prenom>.</SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Mail : <INPUT style="WIDTH: 380px; HEIGHT: 25px" size=37 name=prenom></SPAN></P></TD></TR>
<TR style="mso-yfti-irow: 3; mso-yfti-lastrow: yes">
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: black 1pt solid; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 189.7pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: black 1pt solid; PADDING-TOP: 0cm; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt" vAlign=top width=316>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Section :</SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Ecole de natation </SPAN><INPUT value=M type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Compétition<SPAN style="mso-spacerun: yes"> </SPAN>élite 1<INPUT value=M type=radio name=sexdedzsze></SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">élite 2 </SPAN><INPUT value=M CHECKED type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Mercredi loisirs </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>Perfectionnement </SPAN><INPUT value=M type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Mardi<SPAN style="mso-spacerun: yes"> </SPAN>17-18 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>18-19 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>19-20 </SPAN><INPUT value=M type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">jeudi<SPAN style="mso-spacerun: yes"> </SPAN>17-18 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>18-19 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>19-20 </SPAN><INPUT value=M type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Mardi / Jeudi 17-18 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>18-19 </SPAN><INPUT value=M type=radio name=sexdedzsze><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"> 19-20 </SPAN><INPUT value=M type=radio name=sexdedzsze></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Aquagym</SPAN><INPUT value=M type=radio name=sexdedzsze></P></TD></TR></TBODY></TABLE></DIV>
<DIV class=Section1 align=center><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"></SPAN> </DIV>
<DIV class=Section1 align=center><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Réduction : <SELECT name=fonction> <OPTION value=""></OPTION> <OPTION selected value=Pour 30€ famille même d'une membres 2>Pour 2 membres d'une même famille 30€</OPTION><OPTION value=pour famille même d'une membres 50€ 3>Pour 3 membres d'une même famille 50€</OPTION></SELECT></SPAN></DIV>
<DIV class=Section1 align=center><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"></SPAN> </DIV>
<DIV class=Section1 align=center><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"></SPAN><U><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Le certificat médical est obligatoire avant l'accès au bassin</SPAN></U><SPAN style="LINE-HEIGHT: 115%; FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">, sinon le nageur ne pourra pas participer à son cours, et ne sera pas accepté au bord du bassin.</SPAN></DIV>
<DIV class=Section1 align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN> </DIV>
<DIV class=Section1 align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Recommandation Médicale : <INPUT style="WIDTH: 794px; HEIGHT: 20px" size=74 name=prenom><BR></DIV></SPAN><B style="mso-bidi-font-weight: normal"><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN></U></B>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=left><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"> </SPAN></P>
<P style="TEXT-ALIGN: justify; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Montant:<SELECT name=fonction> <OPTION value=""></OPTION> <OPTION value=a>Ecole Natation: 120€</OPTION> <OPTION value=b>Compétition élite 1: 165€</OPTION> <OPTION value=c>Compétition élite 2: 165€</OPTION> <OPTION value=d>Mardi ou jeudi: 120€</OPTION> <OPTION value=e>Mardi et Jeudi: 155€</OPTION> <OPTION value=f>Mercredi Après-Midi: 145€</OPTION> <OPTION value=g>Mardi ou jeudi masters: 145€</OPTION> <OPTION selected value=h>Mardi et Jeudi masters: 190€</OPTION> <OPTION value=i>Aquagym saison: 240€</OPTION> <OPTION value=j>Aquagym demi-saison: 125€</OPTION></SELECT></SPAN></U></B><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN><B style="mso-bidi-font-weight: normal"><U>Paiement :<SPAN style="mso-spacerun: yes"> <SELECT name=fonction> <OPTION value=Cheque>Cheque</OPTION> <OPTION selected value=Espece>Espece</OPTION><OPTION value=autre>Autre</OPTION></SELECT></SPAN></U></B></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=left><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Chèque(s) </SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"> </SPAN>nombre :<SELECT style="WIDTH: 62px" name=fonction><OPTION selected value=""></OPTION><OPTION value=1>1</OPTION><OPTION value=2>2</OPTION><OPTION value=3>3</OPTION><OPTION value=4>4</OPTION></SELECT> mois : <SELECT style="WIDTH: 106px" name=fonction><OPTION selected value=""></OPTION><OPTION value=janvier>janvier</OPTION><OPTION value=fevrier>février</OPTION><OPTION value=mars>mars</OPTION><OPTION value=avril>avril</OPTION><OPTION value=mai>mai</OPTION><OPTION value=juin>juin</OPTION><OPTION value=juillet>juillet</OPTION><OPTION value=aout>août</OPTION><OPTION value=septembre>septembre</OPTION><OPTION value=octobre>octobre</OPTION><OPTION value=novembre>novembre</OPTION><OPTION value=decembre>décembre</OPTION></SELECT><SELECT style="WIDTH: 106px" name=fonction><OPTION selected value=""></OPTION><OPTION value=janvier>janvier</OPTION><OPTION value=fevrier>février</OPTION><OPTION value=mars>mars</OPTION><OPTION value=avril>avril</OPTION><OPTION value=mai>mai</OPTION><OPTION value=juin>juin</OPTION><OPTION value=juillet>juillet</OPTION><OPTION value=aout>août</OPTION><OPTION value=septembre>septembre</OPTION><OPTION value=octobre>octobre</OPTION><OPTION value=novembre>novembre</OPTION><OPTION value=decembre>décembre</OPTION></SELECT><SELECT style="WIDTH: 106px" name=fonction><OPTION selected value=""></OPTION><OPTION value=janvier>janvier</OPTION><OPTION value=fevrier>février</OPTION><OPTION value=mars>mars</OPTION><OPTION value=avril>avril</OPTION><OPTION value=mai>mai</OPTION><OPTION value=juin>juin</OPTION><OPTION value=juillet>juillet</OPTION><OPTION value=aout>août</OPTION><OPTION value=septembre>septembre</OPTION><OPTION value=octobre>octobre</OPTION><OPTION value=novembre>novembre</OPTION><OPTION value=decembre>décembre</OPTION></SELECT><SELECT style="WIDTH: 106px" name=fonction><OPTION selected value=""></OPTION><OPTION value=janvier>janvier</OPTION><OPTION value=fevrier>février</OPTION><OPTION value=mars>mars</OPTION><OPTION value=avril>avril</OPTION><OPTION value=mai>mai</OPTION><OPTION value=juin>juin</OPTION><OPTION value=juillet>juillet</OPTION><OPTION value=aout>août</OPTION><OPTION value=septembre>septembre</OPTION><OPTION value=octobre>octobre</OPTION><OPTION value=novembre>novembre</OPTION><OPTION value=decembre>décembre</OPTION></SELECT></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=left><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">MRA </SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"> n° carte <INPUT style="WIDTH: 170px; HEIGHT: 25px" size=16 name=prenom>  n°établissement : <INPUT style="WIDTH: 183px; HEIGHT: 25px" size=18 name=prenom></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=left><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">CAF <INPUT type=checkbox name=C1></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=left><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><INPUT type=checkbox name=C1> Je désire un justificatif pour mon CE<SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 11pt; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-ansi-language: FR; mso-bidi-language: AR-SA"></P></SPAN>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Je reconnais avoir pris connaissance du règlement intérieur (disponible au bureau du club) et m'y soumettre.</SPAN></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">J'autorise le club des Dauphins de Guilherand Granges à utiliser les images réalisées lors des entraînements, des manifestations sportive ou non.<SPAN style="mso-spacerun: yes"> </SPAN></SPAN></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"><SPAN style="mso-spacerun: yes"></SPAN>OUI<SPAN style="mso-spacerun: yes"> <INPUT value=M type=radio name=photo></SPAN></SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"><SPAN style="mso-spacerun: yes"> </SPAN>NON<SPAN style="mso-spacerun: yes"> <INPUT value=M CHECKED type=radio name=photo></SPAN></SPAN></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Les informations recueillies font l'objet d'un traitement informatique. En application de l'Art 34 de la loi du 06/01/1978 vous bénéficiez d'un droit à l'accès et de rectification des informations qui vous concernent. Si vous souhaitez exercer ce droit et obtenir une communication de ces informations, veuillez vous adresser au secrétariat du club.</SPAN></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Avoir pris connaissance des assurances sportives complémentaires pouvant être contractées auprès e la FFN/<SPAN class=SpellE>Marsch</SPAN>.</SPAN></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><I style="mso-bidi-font-style: normal"><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Tout engagement est annuel, aucun remboursement, même partiel ne sera effectué, après le 25 septembre 2010.</SPAN></U></I></P>
<P style="TEXT-ALIGN: justify; LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><B style="mso-bidi-font-weight: normal"><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Autorisation des parents pour les enfants mineurs :</SPAN></U></B><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"> Je, soussigné <INPUT style="WIDTH: 258px; HEIGHT: 25px" size=24 name=prenom> Autorise <SELECT name=fonction> <OPTION value=""></OPTION> <OPTION selected value=""></OPTION> <OPTION value=mon fils>mon fils</OPTION> <OPTION value=ma fille>ma fille</OPTION></SELECT><INPUT style="WIDTH: 302px; HEIGHT: 25px" size=29 name=prenom> A suivre les cours de natation et l'entraînement sportif. J'autorise la Fédération Française de Natation et son représentant légal à faire pratiquer sur l'enfant désigné ci-dessus tout acte médical ou chirurgicale d'urgence que nécessite son état de santé, accepte toute hospitalisation dans l'établissement le plus proche. Autorise les déplacements au cours des stages </SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt">Veuillez dater et signer en précédent de la mention « lu et approuvé »<SPAN style="mso-spacerun: yes"> </SPAN></SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal align=center><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"><SPAN style="mso-spacerun: yes"></SPAN></SPAN> </P>
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<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: black 1pt solid; PADDING-BOTTOM: 0cm; PADDING-LEFT: 5.4pt; WIDTH: 220.1pt; PADDING-RIGHT: 5.4pt; HEIGHT: 36.5pt; BORDER-TOP: black 1pt solid; BORDER-RIGHT: black 1pt solid; PADDING-TOP: 0cm; mso-border-alt: solid black .5pt" vAlign=top width=367>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN> </P></TD></TR>
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<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">Cadre réservé : inscription saisie dans BA </SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'">n°............</SPAN></P>
<P style="LINE-HEIGHT: normal; MARGIN-BOTTOM: 0pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"><SPAN style="mso-spacerun: yes"></SPAN><SPAN style="mso-spacerun: yes"></SPAN>Inscription FFN</SPAN><SPAN style="FONT-FAMILY: Symbol; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-char-type: symbol; mso-symbol-font-family: Symbol"><SPAN style="mso-char-type: symbol; mso-symbol-font-family: Symbol">^</SPAN></SPAN><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"> n° licence</SPAN></P></TD>
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<P class=MsoNormal> </P></TD></TR>
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<P style="LINE-HEIGHT: normal" class=MsoNormal><SPAN style="FONT-FAMILY: 'Times New Roman','serif'"></SPAN></P>
<P style="TEXT-ALIGN: center; LINE-HEIGHT: normal" class=MsoNormal align=center><U><SPAN style="FONT-FAMILY: 'Times New Roman','serif'; FONT-SIZE: 10pt"><SPAN style="mso-spacerun: yes"></SPAN></SPAN></U><INPUT value=Envoyer type=submit><INPUT value=Reset type=reset></P></TD></FORM></TR></TBODY></TABLE>