Registration Form

Phone number*

Personal activation code*

Phone number*

I accept the general conditions and the privacy conditions of Carrefour Belgium NV.

Phone number*

Amount of the reload*

Payment method*

First name*

Last name*

Date of birth (DD/MM/YYYY)*

/ /

Cardholder's place of birth*

E-mail (optional)

I accept the general conditions and the privacy conditions of Carrefour Belgium NV.