|
Team-Captain:
Name: _________________________________firstname:______________________________________
Adress:______________________________________________________________________________
PLZ:
_____________Ort:________________________________________________________________
Phone:________________________
E-Mail:________________________________________________
Staffel-Name:
____________________________________________________________________________________________________
|
|
Cyclist:
Name: ____________________________firstname:______________________________
Sex: M F
Age on 24.08.08: ___________ Signature:______________________________________
( ) ( ) |
|
Swimmer:
Name: ____________________________firstname:____________________
__________Sex M
F
Age on 24.08.08 __________ Signature:
_____________________________________
( ) ( ) |
|
Runner
Name: ____________________________ firstname: ______________________________Sex
M F
Age on 24.08.08: ___________Signature:
______________________________________
( ) ( )
|
Competitors younger than
18 years need a supplementary signature of a parent!
The Competitors ( resp. Parents ) declare by signature their agreement
with the
conditions –
participation at own responsibility and risk. The promoter is not liable for any
damage cases whatever
Pre-Registration
is necessary.
The admission fee is 36,--
€ (Euro) for the whole team.
The
enrolment becomes valid with the receipt of the fee € 36,-- under the name of the account number:
140102633
(Kto.Nr.), KSK Waldmohr, BLZ: 540 515 50
Adress:
Information:
RadSportFreunde Waldmohr e.V.
www.staffel-triathlon.de
Staffel-Triathlon
post@staffel-triathlon.de
Postfach 14 09
Fax:
0 63 73 / 89 13 37
66912 Waldmohr
Tel.: 0 63 73 / 92 86 oder 13 22
E-Mail: post@staffel-triathlon.de
( Ausdruck der Seite durch drücken der Tasten
Strg + p )