NATION:______________ - uipmworld.org  · Web view2018 Nu Skin Senior European Championships....

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2018 Nu Skin Senior European ChampionshipsSzékesfehérvár, Hungary, 17.07-23.07.2018

ENTRY FORM “B” (Preliminary)

Return no later than 25th June

Nation: _______________________ Contact Person:_______________________

Tel : ______________ Fax :_______________ E Mail: ______________________

Male AthletesSurname

First Name ID Number * Date of Birth

Female AthletesSurname

First Name ID number * Date of Birth

* Attention: No athlete will be admitted to the competition without a valid international license

Officials Surname First Name Function

Return to: Hungarian Modern Pentathlon AssociationTel.: +36 1 460 68 85 Fax: +36 1 460 68 86Email: karman.sandor@pentathlon.hu and hmpa@pentathlon.hu

Signature: _______________________________________

Name (printed):_______________________ Date:__________

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