Form of registration A

Your identity

First name*

Name*

Password*

Birthdate (year/month/date)*

E-mail*

Adres*

Street Address City ZIP / Postal Code Country

Website

Do you wear the patronym Canivet, Canivez or any derived surname ?

Do you think is related to the family Canivet?

Would you like to receive our newsletter?

Do you wish to attend the next gathering?

Remarks

language*

Gender

Lineage number

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Email

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