4th Marathon of Wine cities (and half-Marathon)

www.maratonacittadelvino.com

A

VILLACH BLED LUBIANA

Tarvisio

Tolmezzo

SLO

S. Daniele del Friuli

4

Cividale

UDINE del Friuli PORDENONE

th

Buttrio

GORIZIA

Manzano

San Giovanni al Natisone

VENEZIA

TRIESTE

CITIES OF WINE MARATHON

(AND HALF-MARATHON)

SUNDAY, 7 OCTOBER 2012

start and arrival in San Giovanni al Natisone (Udine / Italy)

Partner Istituzionali

Partner Istituzionali

San Giovanni al Natisone

Manzano

Buttrio

Premariacco

ORGANIZZAZIONE:

FEDERAZIONE ITALIANA DI ATLETICA LEGGERA

Cividale del Friuli

Prepotto

Radio Ufficiale

Dolegna del Collio

Corno di Rosazzo

Registration form

4

th

citIES OF WINE maratHon

(AND HALF-MARATHON)

Marathon

Half Marathon

Marathon Handbike

Half Marathon Handbike

Skiroll (21,0975 km)

Roller (21,0975 km)

Surname

Gender

Date of birth (dd-mm-yyyy)

Name

Address

MF Zip Code

Town

Province

Mobile

Country

E-mail

Club

Celiac Athlete

Registration Method ❏

❏

Registration fees Marathon

on-line directly on the site: www.maratonacittadelvino.com by fax n° 0432 673511 to the attention of Elisa Nonino

NB Registrations will be closed on thursday 4 October 2012

€ 15,00 € 20,00 € 25,00 € 30,00 € 7,00

Half Marathon

Payment Method ❏ ❏

❏

❏

before March, 19th 2012 before June, 18th 2012 before September, 24th 2012 before October, 4th 2012 ❏ FIDAL daily card for not enrolled athletes

Credit Card (only for on-line registration) Deposit on Post Account n. 96723176 in the name of: A.S.D. PODISMO BUTTRIO Description: “Iscrizione Maratona o Maratonina delle città del vino” Credit transfer IBAN: IT 37 K 0548463690027570704566 Description: “Iscrizione Maratona o Maratonina delle città del vino” Cash

before March, 19th 2012 before June, 18th 2012 before September, 24th 2012 before October, 4th 2012 ❏ FIDAL daily card for not enrolled athletes

€ 12,00 € 14,00 € 17,00 € 20,00 € 7,00

Skiroll Roller Disabled athletes

€ 15,00 € 5,00 free

LONDON MARATHON Date

Signature

By signing this form, the competitor declares that he has read and accepted the regulations of the race, that he has not given false informations and that he accepts, according to the law n. 675/96, the handling of his personal data only for the purposes required by this event (competitors list, results and possible relevant communications following the event).