Provisional Entry Form – before 20.04.2018

The Provisional Entries will close in

Club/Federation*
Head of delegation*
Address
Postal code
City/Town
Country*
Phone/Mobile
E-mail*

Will you book through the OC?
 YES NO

Number of P/G Youth Age Group 1 (11-16) Age Group 2 (12-18) Junior (13-19) Senior
W2
M2
MX2
W3
M4
Head of Delegation
Team Manager
Coach
Judge
Doctor
Physioterapist
Other (specify)
Notes


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Approved by:

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