2. IRR-World-Championships | Anmeldung / registration

Name / last name:

Vorname / first name:

E-Mail:

Geburtsdatum / date of birth:

Land / country:

Adresse / adress:

Postleitzahl / zip-code:

Stadt / city:

Telefon (inkl. Vorwahl) / phone (incl. area code):

Disziplinen (max. 3 + Staffel) / competitions (max. 3 + relay):

100m200m400m800m1500m3000m5000m10000m4x100m relay4x400m relay

Geschlecht / sex:

Mann / male Frau / female

Bemerkungen / notes:

Bemerkungen / notes

Anmeldegebühr / registration fee: 10€

SWIFT: BCCVIT31011
IBAN: IT56O0872624600000000113835
registered to: Associazione Retrorunning via Provinciale, 8 - 55041 Camaiore (LU) Italy


Anmeldefrist / term of application: 31.08.2008