Anmälningsblankett till IVVM i Budapest


 
   Entry form
 
 
    WMA indoor championships
        March 25-30. 2014 Budapest, Hungary
 
    Athlete   Companion
 
SURNAME                                                            
FIRTS NAME                                                            
NATIONALITY                                                            
ADDRESS                                                            
ZIP CODE              CITY                                            
COUNTRY                                                            
TELEPHONE                                                            
E-MAIL                                                            
CLUB                                                            
  DAY   MONTH YEAR  
DATE OF BIRTH                      
 
AGE ON MARCH 25TH 2014 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94   95+
WOMEN                                                    
MEN                                                    
 
EVENTS (PUT AN "X" BESIDE EVENTS ENTERED     "X"         BEST PERFORMANCE IN 2013-14 (COMPULSORY)  
60m                                    
200m                                    
400m                                    
800m                                    
1500m                                    
3000m                                    
60m hurdles                                    
3000m track race walk                                    
high jump                                    
pole vault                                    
long jump                                    
triple jump                                    
shot put                                    
weight throw                                    
pentathlon                                    
 
WINTER THROWING, NON-STADIA
hammer throw                                    
discus throw                                    
javelin throw                                    
10km road race walk                                    
8km cross country                                    
half marathon                                    
Entry fees          
FEES EURO NUMBER TOTAL    
Registration fee (compulsory) 30   30.00    
WMA Athletes fee (compulsory) 28   28.00    
Each individual event (excluding Pentathlon and half marathon) 26        
Pentathlon 35        
Half marathon 40        
Printed result-book 20        
Result-book on DVD 10        
Accompanying person 26        
Accompanying person under age 14 16        
TOTAL          
Note: registration fee does not include any individual event.    
           
There shall be no entry fees charged for the 4x200m relay event and team events. Teams must only be entered at the championships and not before.    
           
8. Disclaimer Clause          
'I hereby declare that I am in good health and will be properly conditioned for the events I have entered. I relieve World Masters Athletics, the Local Organizing Committee, IAAF, all Officials, Judges, Volunteers and other technical representatives and medical personnel of any responsibility for any injury, loss or damage to me or my property which I may sustain in the course of or in connection with these championships. I authorize the use of my name, voice or picture and any information on this entry form to be used without payment to me in any broadcast, telecast, promotion or advertising or in any way related to this championship'.    
           
9. DRUG TESTING AND DISCLAIMER CONSENT          
I, being a competitor of 6th WMA World Indoor Athletics Championships in Budapest, acknowledge that Drug Testing will be conducted under the WMA/IAAF Anti-Doping Rules and Regulations and hereby give my consent to be subject to any drug testing requirements at the said Championships'.      
NOTE: If selected for drug testing Competitors must declare any/all medications being used by them on the doping control form. Any athlete using a prohibited substance as defined in the Regulations, must apply for an exemption (TUE) to the WMA Anti-Doping and Medical Committee. If an exemption is refused the prohibited substance(s) concerned may not be used and should you be selected for testing and the test proves positive this may result in a suspension. Please note that no other medical certificate(s) will be accepted in substitution for a TUE certificate. If you are granted a TUE exemption certificate, this must be with you at all times along with proof of identification, and must be produced at the Doping Control Centre if you are selected for a drug test. Details of prohibited substances and all Anti-Doping procedures are available on the IAAF (www.iaaf.org) website, the WMA (www.world-masters-athletics.org) website and your IAAF affiliated Federation. (See also Doping Control section later.)    
           
10. PAYMENTS           
Participants must send this entry form and entry fees to their national masters athletics association/WMA affiliate. (Paper entries)
National Masters Affiliates must validate all paper entries or data in the online system and additionally send all paper entries and all fees to the LOC address as below: (1)    
           
11. AGREEMENT FOR USE OF ENTRY DATA AND MEDICAL DATA IN DATABASE    
I also as a an entrant agree to allow WMA to hold my entry details and medical data in the WMA Registration Database, to be used by WMA to provide me with my unique masters Registration card as in the entry guidelines and for emergency medical treatment, as well as to contact me through WMA, the Regional Association or the LOC for these championships only.      
           
           
           
DATE   ATHLETE'S SIGNATURE    
Participants must send this entry form and entry fees to their national masters athletics association/WMA affiliate. (Paper entries)
           
CLOSING DATE FOR ALL ENTRIES   03 February, 2014 
“Note the Online system will then be closed”
           
CERTIFICATION OR STAMP OF NATIONAL BODY        
DATE SIGNATURE      
           
CANCELLATION CONDITIONS
There will be no refund of any fees for any reason after the closing date for entries.
Unless under medical grounds, with documented evidence of any such medical conditions.