Age at the
11/12/2005:
years Category WMA :
(Example W35, M45)
Affiliated entity to WMA
to which belongs:
National Association
E mail
:
Phone / Fax :
Language
I declare in
irrevocable form, on my behalf like in that of my heirs and
executors and I exempt from all responsibility to the organizer of
this World Championship of Ultramaraton 100K to the WMA World
Master Association, the IAU International Association Ultramaraton,
to the Organizing Committee, to the Asociación Civil Bariloche de
Atletas Veteranos, to the Confederación Atletas Veteranos de la
República Argentina (CAVRA), auspiciantes and authorities of the
realization place that it investigates, for any birdcall against the
aforementioned ones that it could arise for reasons of some lesion,
accident, partial or total inability and death that I could suffer
during the above test, in which I intervene.
Likewise manifesto that I have been examined recently by a doctor
whose enclosed certificate that determined that my physical
condition and health are adapted to carry out without risk my
holding in this competition.
ARGENTINA
