|
The application
form of 11th year of the
AUTHOR - KRΑL UMAVY 2004 marathon |
|||||||||||||
|
MOUNTAIN BIKES |
|||||||||||||
|
Participation in year
( circle ):
97 98 99
00 01 02
03 |
|||||||||||||
|
Surname: |
Name: |
||||||||||||
|
Street: |
Number: |
||||||||||||
|
Town/Country: |
Postal Code:
|
||||||||||||
|
Telephone |
Birthdate: |
|
|
|
|
|
|
/ |
|
|
|
|
|
|
e-mail: |
|||||||||||||
|
cathegory ( circle the correct
one ) |
|||||||||||||
|
SHORTER track |
LONGER track |
Explanatory notes |
|||||||||||
|
ZK1 |
ZD1 |
Women Year
of birth 1965 and younger |
|||||||||||
|
ZK2 |
ZD2 |
Women Year
of birth 1955 - 1964 |
|||||||||||
|
ZK3 |
ZD3 |
Women Year
of birth 1954 and older |
|||||||||||
|
MK1 |
MD1 |
Men Year
of birth 1965 and younger |
|||||||||||
|
MK2 |
MD2 |
Men Year
of birth 1955 - 1964 |
|||||||||||
|
MK3 |
MD3 |
Men Year
of birth 1954 and older |
|||||||||||
|
Size of memorial T-shirt: S
M L XL
XXL |
|
I know the race takes
place in ful traffic at my own risk. I will keep its rules. I confirm that I am healthy
and physically fit and I won't make
the organizer responsible for injuries, thefts and losses
during the race. I confirm I agree with compiling
my initials by Triatlon klub Klatovy. Triatlon klub
Klatovy will protect them in a way of § 11 law No. 101/2000. |
|
In
.
date
Signature
.
|
|
Complement of application form if you are not 18: Parent, who is aware
of health condition of his son/daughter
.
..
birthdate
.,
gives agreement for entering the race AUTHOR Krαl umavy 2004 MTB and
is fully responsible for injuries of his child. In
date
.
.
Parent signature
Parent birthdate
.... |
|
" Print, cut off
and complete items in bold legibly and in block letters. Sign!" For further information see propositions. |