Entry Form
9th Masters' International Speed Skating CRITERION, Erfurt/Germany, 01 - 02 Dec 2012
 
Please fill in this entry form completely and submit it. It will reach the organizer of the competition very fast.  * = Duty Area.
Only use latin letters. Entry is expected until Monday 19 Nov 2012 at the latest. Entry Form only for Foreign skaters, not for German skaters (see Announcement).
You will be informed by email about the arrival of your entry at the organizer. Additionally a list of entries can be found at:  www.eisschnelllauf-erfurt.de
 

Family name *

First name *

Complete postal address *
(street, no., postal code, town, province, country)

Email address *

Telephone

Cellphone

Telefax

Male(m)/female(f) *

Date of birth *

Starting for nation *

National license no. *

Club

Training times before Friday 30 Nov:
Yes, from date *

Remarks

Deposit:
A deposit of EUR 20,00 per participant has to be issued to the following bank account parallell to the entry with this electronic form to be registrated at the List of Competitors: Eissportclub Erfurt, Sparkasse Mittelthüringen, Account-No.: 163003742, Bank Code: 820 510 00, IBAN: DE67 8205 1000 0163 0037 42, BIC (SWIFT-Code): HELADEF1WEM, Reason for payment: Name of skater, 9th Masters' Criterion Erfurt 2012
Waiver:
I hereby declare, that I am in good health and I am properly conditioned for the competitions. I absolutely relieve the organizer, the ISU, the IMSSC and the IMSSG of any responsibility for any injury, loss or damage to myself or my property or to accompanying persons or their property which may sustain in the course of or in connection with the 9th Masters' International Speed Skating CRITERION 2012 in Erfurt/Germany. Included in my declaration is the non-liability of the organizer according to ISU Rule 119, as expressed in the announcement of the competition.

I agree with the Deposit and the Waiver *

 
    
Several entries:   For sending several entries it may be necessary, not only to press the "Reset"-button and to fill in the form with the data of the following entry and to press again the "Submit"-button, but to reload the entry form for every new entry (depending on the browser used).

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