The application form of 11th year of the AUTHOR - KRÁL ŠUMAVY 2004 marathon
ROAD BIKES
Participation in year ( circle ): 94 95 96 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	MIDDLE track	LONGER track		Explanatory notes
ZK1	ZS1	ZD1		Women – Year of birth 1965 and younger
ZK2	ZS2	ZD2		Women – Year of birth 1955 - 1964
ZK3	ZS3	ZD3		Women – Year of birth 1954 and older
MK1	MS1	MD1		Men – Year of birth 1965 and younger
MK2	MS2	MD2		Men – Year of birth 1955 - 1964
MK3	MS3	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 full 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 – Král Šumavy 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!" Send 1st September at the latest. For further information see propositions.