Registration form

I WΑΝΤ TO PARTICIPATE IN THE ROAD RUNNING *
---350 m1 Km6 Kms10 Kms

NAME *

SURNAME *

NAME OF FATHER OR MOTHER *

NATIONALITY *

ADDRESS IN SAMOS *

DATE OF BIRTH *

MOBILE PHONE NUMBER *

EMAIL *

TERMS OF ACCEPTANCE *

I hereby declare in full responsibility, that I have recently passed medical examinations and I have no health condition, that may place me at risk if I participate in the Road Running.
I agree that my name and my photo be published in printed and electronic media, in relation to the results, organization and promotion of the Road Running.
NOTE: For children participating in the 350 m and 1 km Road Running, the above declarations should be signed by their parent / guardian.

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