Did you know that at Club Imaginarium we always get a head start when we play?

Grandparent Registration | Date 09/09/2010

If you would like to take advantage of the benefits of Club Imaginarium, complete the new member registration form, print it out and send it signed grandfather/grandmother by

by post to:

CLUB IMAGINARIUM
68 Lower George's Street - Dun
Laoghaire - Co. Dublin - (Ireland)

FAX:

CLUB IMAGINARIUM
01 2841543

( * mandatory fields )

Grandparents' information *

You must fill in the details of at least one of the two grandparents.

Grandfather's name Grandfather's first surname Grandfather's second surname

Contant details Street type* Address 1* Address 2 Adress 3 Postcode* (99999) City/Town County* County/Province Landline telephone* (999999999999999) Mobile (999999999999999) e-Mail

Grandsons

* Children younger than 9 years old

Name* Surname 1* Surname 2*

Date of birth * (format: dd/mm/yyyy) Boy Girl

Name/Surname	Date of birth *

I wish to subscribe to the Imaginarium's News Bulletin * I declare that I live in Ireland, in another European country, or in Latin America.*

Information provided will be included in the Imaginarium, S.A. files.You have the right to access, correct, oppose or delete this information by contacting Imaginarium, Customer Services, Plataforma Logística de Zaragoza, Calle Osca, no. 4, 50197 Zaragoza, Spain.

Did you know that at Club Imaginarium we always get a head start when we play?

Grandparent Registration | Date 09/09/2010

by post to:

FAX:

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