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Section 1 of 2
8ος Γύρος Πάρου/8th Gyros Parou 2017
ΦΟΡΜΑ ΕΓΓΡΑΦΗΣ PARTICIPATION FORM
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ONOMA /ΝΑΜΕ
ONOMA /ΝΑΜΕ
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ΕΠΩΝΥΜΟ/SURNAME
ΕΠΩΝΥΜΟ/SURNAME
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ΟΝΟΜΑ ΠΑΤΡΟΣ / FATHERS NAME
ΟΝΟΜΑ ΠΑΤΡΟΣ / FATHERS NAME
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ΕΘΝΙΚΟΤΗΤΑ/ NATIONALITY
ΕΘΝΙΚΟΤΗΤΑ/ NATIONALITY
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ΗΜΕΡΟΜΗΝΙΑ ΓΕΝΝΗΣΗΣ/ DATE OF BIRTH
ΗΜΕΡΟΜΗΝΙΑ ΓΕΝΝΗΣΗΣ/ DATE OF BIRTH
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ΦΥΛΛΟ/SEX
ΦΥΛΛΟ/SEX
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ΑΝΤΡΑΣ/ MAN
ΓΥΝΑΙΚΑ /WOMAN
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ΔΙΕΥΘΥΝΣΗ / ADRESS
ΔΙΕΥΘΥΝΣΗ / ADRESS
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ΤΑΧ. ΚΩΔ. / P.O. BOX
ΤΑΧ. ΚΩΔ. / P.O. BOX
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ΠΟΛΗ /TOWN
ΠΟΛΗ /TOWN
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ΧΩΡΑ /COUNTRY
ΧΩΡΑ /COUNTRY
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ΗΛΕΚΤΡΟΝΙΚΗ ΔΙΕΥΘΥΝΣΗ/E-MAIL
ΗΛΕΚΤΡΟΝΙΚΗ ΔΙΕΥΘΥΝΣΗ/E-MAIL
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ΤΗΛΕΦΩΝΟ /TELEPHONE
ΤΗΛΕΦΩΝΟ /TELEPHONE
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ΟΜΑΔΑ Η ΧΟΡΗΓΟΣ / CLUB OR SPONSOR
ΟΜΑΔΑ Η ΧΟΡΗΓΟΣ / CLUB OR SPONSOR
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ΜΕΓΕΘΟΣ ΜΠΛΟΥΖΑΣ/ T SHIRT SIZE
ΜΕΓΕΘΟΣ ΜΠΛΟΥΖΑΣ/ T SHIRT SIZE
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SMALL
MEDIUM
LARGE
X-LARGE
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ΠΡΟΗΓΟΥΜΕΝΗ ΔΡΟΜΙΚΗ ΕΜΠΕΙΡΙΑ ΑΝΩ ΗΜΙΜΑΡΑΘΩΝΙΟΥ(απόσταση, χρονιά, επίδοση) / PREVIOUS RUNNING EXPERIENCE OVER HALF MARATHON(distance, date, time)
ΠΡΟΗΓΟΥΜΕΝΗ ΔΡΟΜΙΚΗ ΕΜΠΕΙΡΙΑ ΑΝΩ ΗΜΙΜΑΡΑΘΩΝΙΟΥ(απόσταση, χρονιά, επίδοση) / PREVIOUS RUNNING EXPERIENCE OVER HALF MARATHON(distance, date, time)
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ΣΥΝΟΔΟΙ (ονοματεπώνυμο,ηλικία)/ ESCORTS (name, surname, age)
ΣΥΝΟΔΟΙ (ονοματεπώνυμο,ηλικία)/ ESCORTS (name, surname, age)
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ΔΙΑΘΕΤΩ ΤΟΝ ΑΠΑΡΑΙΤΗΤΟ ΕΞΟΠΛΙΣΜΟ ΓΙΑ ΝΥΧΤΕΡΙΝΟ ΤΡΕΞΙΜΟ/ I HAVE ALL NECESSARY EQUIPMENT FOR NIGHT RUNNING
ΔΙΑΘΕΤΩ ΤΟΝ ΑΠΑΡΑΙΤΗΤΟ ΕΞΟΠΛΙΣΜΟ ΓΙΑ ΝΥΧΤΕΡΙΝΟ ΤΡΕΞΙΜΟ/ I HAVE ALL NECESSARY EQUIPMENT FOR NIGHT RUNNING
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NAI / YES
ΟΧΙ / NO
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Section 2 of 2
ΟΡΟΙ ΚΑΙ ΠΡΟΥΠΟΘΕΣΕΙΣ/ TERMS AND CONDITIONS
Με την παρούσα δηλώνω ρητά και ανεπιφύλακτα ότι σε καμία περίπτωση ούτε εγώ, ούτε οι οικείοι μου, δε θα στραφούμε ή θα προβάλλουμε απαίτηση εναντίων των διοργανωτών ή εκπροσώπων αυτών ή των χορηγών ή της εποπτεύουσας αρχής σε περίπτωση υλικής, σωματικής ή ηθικής βλάβης μου εξαιτίας του ως άνω αγώνα. Γνωρίζω πως η εκδήλωση θα λάβει μέρος σε δημόσιο χώρο, όπου τμήματά του ενδέχεται να είναι ανοικτά στην κυκλοφορία και στο κοινό, που σημαίνει πως ελλοχεύουν όλοι οι κίνδυνοι μια τέτοιας διαδρομής. Δηλώνω ότι έχω περάσει από πρόσφατο ιατρικό έλεγχο και ότι μου επιτρέπεται να λάβω μέρος σε σχετικό αγώνα. Αναλαμβάνω πλήρως την ευθύνη σε περίπτωση ατυχήματός μου κατά τη διάρκεια του αγωνίσματος, απαλλασσομένων πλήρως και ολοσχερώς των οργανωτών του αγώνα. Επιτρέπω να χρησιμοποιηθούν φωτογραφίες και βίντεο που θα ληφθούν κατά την διάρκεια της εκδήλωσης και συναφών δραστηριοτήτων για κάθε νόμιμη χρήση από τους διοργανωτές και χορηγούς.
I hereby declare unreservedly that in no case nor I, nor the familiar , I will not turn or claim against the organizers or their representatives or the sponsors or the supervisory authority in a material , physical or moral harm me because of that race. I know that the event will take place in a public area where parts may be open to traffic and the public , which means that there are risks of witch I am aware. I declare that I recently had a medical check up and that I am able to participate in such an event. I take full responsibility if I am injured during the race and exempt fully and completely the organizer of the event . I allow the use of photographs and videos taken during the event and related activities for any legitimate use of the organizers and sponsors.
I hereby declare unreservedly that in no case nor I, nor the familiar , I will not turn or claim against the organizers or their representatives or the sponsors or the supervisory authority in a material , physical or moral harm me because of that race. I know that the event will take place in a public area where parts may be open to traffic and the public , which means that there are risks of witch I am aware. I declare that I recently had a medical check up and that I am able to participate in such an event. I take full responsibility if I am injured during the race and exempt fully and completely the organizer of the event . I allow the use of photographs and videos taken during the event and related activities for any legitimate use of the organizers and sponsors.
O/H δηλών-ούσσα / the declarant
O/H δηλών-ούσσα / the declarant
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ΣΥΜΦΩΝΩ / I AGREE
ΔΕΝ ΣΥΜΦΩΝΩ / I DONT AGREE
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Επιλογή 1
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Επιλογή 1
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