PRIJAVNICA / REGISTRATION FORM / ANMELDUNGSFORMULAR / MODULO DI ISCRIZIONE poslati na / send to / senden / spedire: [email protected] Klub/Club/Verein/ Societa Kontaktna oseba/Contact person/Responsabile/ Kontaktperson Naslov/Adress/ Adresse/Indirizzo Tel.: e-mail: Država/Country/ Staat/Stato 28. 01. 2017 - Veleslalom/Giant Slalom/Riesentorlauf/ Slalom gigante No. Spol/ Sex/ Geschlecht/ Sesso Tekmovalec/Competitor/Contestant/Competitore 1 Leto rojstva/ Year of birth/ Geburtsjahr/ Anno di nascita Male 2 Male 3 Male 4 Male 5 Male 6 Male 7 Male 8 Male 9 Male 10 Male 28. 01. 2017 - Tekma s »POKI«/ “POK” night race/“POK”-Nachtrennen/Gara notturna ‘’POK’’ *: Yes No 29. 01. 2017 - Ekipna tekma/Team race/Gruppenspiel/Gara a squadre*: Select number of your teams *Pravila/Regulations/Bestimmungen/Regole: For both events you will be able to arrange specifics (such as the number of competitors and their names) in the race office upon your arrival onsite. Datum/Date: Podpis/Signature/Unterschrift/Firma: ________________________________ Submit the registration form Alpski smučarski klub Branik Maribor ● Mladinska ulica 29 ● SI-2000 Maribor, Slovenija TEL: +386 (0)41 678 315 ● E-MAIL: [email protected] ● WEB: www.littlefox.si Matična št.: 4067851000 ● ID za DDV: SI 43084052 ● IBAN: SI56 34000 1015350968
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