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
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).