7/26/2019 Officials Application Form WTBF 10.07.2015
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APPLICATION FORM
EUROPEAN MUAYTHAI CHAMPIONSHIP
OCTOBER 14-18 2015
Please fill in clearly in capital letters: Id. Card No.:
* Indicates required field
1.
Name of the organization and country*
2. Full name shown in passport *
First name*
Surname/Family Name*
3. Passport number *
Expire date (DD/MM/YYYY) *
Status:*4. Gender * 5. Position within the National
FederationFemale Male
Official
6. Date of birth * 7. Place of Birth *DD MM YYYY
8. Nationality *
9. Secretary General signature and stamp of the organization
*
Date:
APLICANT DECLRATATION *I do understand the risk of entering into
the Muaythai competition. I do participate at my own free will.
I will take the full responsibility in case of any injury or
accident. I declare not to blame or take anylegal charge on
promoters, officials or the World Thai Boxing Federation or any
third party involved in
organizing this Championship by signing this application
form.
Applicant Signature:
Date:
Please send the application form before 10th
September 2015, to the address below:
Public Relation:[email protected]
Office W.T.B.F: [email protected]
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mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
