The “AETHLIOS” International Long-Distance Running Association
NEMEA-OLYMPIA Olympian Race”
23-24 th May, 2008
ATHLETE’S ENTRY FORM (Photocopy is accepted)
Organization only |
Race number : |
ACCEPTATION : |
Fees : |
ATHLETE
Forename(s)……………………………Surname………………………………….
Nationality………………………….Sex……(M/F) Born in19…………………….
Home address………………..…………………..
Postal (Zip) code………………Town/City……………………Country……………………
Telephone(home/workplace)…………………………….Fax……………….E-mail…………
In the event of unforeseen circumstances whilst in Hellas, the following should be informed :
Mr/Mrs/Miss/Ms………………………….Relationship……………………………..
Telephone…………………………..Fax…..……………..…Other……………….
PERFORMANCE : What has been your best performance (100 km or greater) from 2004 until today (date of application)
- Title of the Race……………………….Date……………………….Distance………………..
- Duration ………………Your Result……………….Nr of Participants……….Nr of Finishers…………………….
- Please provide a certificate of your performance in the event.
NOTE : By signing this Form you undertake the following obligations:
If selected, participants in the “Olympian Race” agree to abide by the rules of the Race and be examined for use of prohibited substances (“doping”)
- Absolve the Organizers from any responsibility for any bodily harm or material damage which may be caused or suffered by participating in the event
- Be obliged to present a medical certificate dated april or may 2008.
- If selected, deposit the sum of EURO 260.- (non-refundable 100 €) in the following bank Account: “AETHLIOS” – Alpha Bank, IBAN GR7401401010101002101177872 – SWIFT CODE CRBAGRAA.
- Note that the number of participants is limited to 100, in the order registration and will not contest the selection made by the Organizers.
- Note that the deadline for registration is 30 april 2008 (or if 100 runners are selected) and Form must mailed to the “AETHLIOS” International Long-Distance Running Association at 12, Thisseos street, GR-15232 Athens, Hellas.
- Provide a passport-type photograph and certificate of performances
- Participants are advised to take-out personal insurance coverage.
Signature of Applicant : ………………………………………….. Date : ………………………