                                       
                                       
                                       
                                       
                                       
          Registration form for                   Registration de    
       BREF V1.21 Shareware version         BREF V1.21 version Shareware
                                       
                                       
                                       
                                       
                                       
If you want to register, and receive    Vous pouvez recevoir la version
the complete version, please send us    complete de ce jeu, en envoyant
20 US dollars (or equivalent in your    100 Francs (chque ou billet)
country currency-no coins) to:          a cette adresse:
                                        
            Franck Gotthold                       Franck Gotthold
           3 rue Jean Moulin                     3 rue Jean Moulin
      18570 La chapelle St Ursin            18570 La chapelle St Ursin 
                FRANCE                                 FRANCE
                                       
 Just mention you're registering BREF   Indiquez moi que vous registrez BREF
 You will receive fastly the complete   Vous recevrez tres rapidement votre
       version that features:            version complte et personnelle
                                                  qui comprend:
                                       
       - the HARD level (25 stages)          - le niveau DUR (25 tapes)
       - 2 PLAYERS MODE !!!                  - LE MODE 2 JOEURS !!!
       - 15 more stages in both              - 15 tapes supplementaire en
         medium and easy levels                niveaux facile et moyen
       - ANTI-BREFS monsters                 - des monstres ANTI-BREFS
       - (...)                               - (...)
                                       
                                       


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English version:

Name,surname:____________________________________________________________

Address:_________________________________________________________________

_________________________________________________________________________

ZIP/Code:________________  City:_________________________________________

Country:_________________________________________________________________

E-mail Address (*): _____________________________________________________


configuration (*):

Processor: ________ Speed: ______ SoundCard: ______________________________

Operating system: _________________________________________________________

comments about BREF and...:
___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________


    Date ________________              Sign here:


(*) means Optional

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Version franaise:

Nom, prnom:_______________________________________________________________

Addresse:__________________________________________________________________

___________________________________________________________________________

Code postal: ____________  Ville: _________________________________________

PAYS: _____________________________________________________________________

E-mail Address (*) : ______________________________________________________

votre configuration (*) :  

Processeur: _________ Vitesse: _________ Carte son: _______________________ 
Systme d'exploitation: ___________________________________________________ 
Autres infos: _____________________________________________________________ 

Commentaires sur BREF + ... :

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________


    Date ________________              Signez ici:

(*) Optionel

merci.
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