REGISTRATION FORM

5 A-SIDE FOOTBALL TOURNAMENT

2° I.P.A. TROPHY VELVET BEACH SENIGALLIA

TEAM NAME ______

Region / Branch/ Police Force/ Relatives / Friends: ______

CITY _______COUNTRY ______

TEL.______FAX______EMAIL______

PLAYERS / DATE OF BIRTH

This form is to be sent to Comitato Esecutivo I.P.A. Senigallia by JULY 30th 2011 through fax 0039 (0)71 7924502 or e-mail: , together with copy of the bank transfer for the registration fee.

Signed

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REGISTRATION FORM

SWIMMING RACES

2° I.P.A. TROPHY VELVET BEACH SENIGALLIA

I.P.A. MEMBER/RELATIVE/FRIENDS: ______

I.P.A. REGION/BRANCH - POLICE FORCE: ______

CITY ______COUNTRY______

TEL. ______FAX______EMAIL______

PLANNED RACES: 25 butterfly; 50 backstroke; 50 breaststroke; 4x50 front crawl; 50 front crawl-relay;

ATHLETE / DATE OF BIRTH / BUTTERFLY / BACKSTROKE / BREASTSTROKE / FRONT CRAWL / RELAY

This form is to be sent to Comitato Esecutivo I.P.A. Senigallia by JULY 30th 2011 through fax 0039 (0)71 7924502 or e-mail: , together with copy of the bank transfer for the registration fee.

N.B. Please indicate the disciplines of interest.

Signed

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REGISTRATION FORM

SKATING COMPETITION

2° I.P.A. TROPHY VELVET BEACH SENIGALLIA

I.P.A. MEMBER/RELATIVE/FRIENDS: ______

I.P.A. REGION/BRANCH - POLICE FORCE: ______

CITY ______COUNTRY______

TEL. ______FAX______EMAIL______

PLANNED RACES: up to 10 years old; up to 16 years old; over 16. All categories will be divided in male and female.

ATHLETE / SEX / DATE OF BIRTH

This form is to be sent to Comitato Esecutivo I.P.A. Senigallia by JULY 30th 2011 through fax 0039 (0)71 7924502 or e-mail: , together with copy of the bank transfer for the registration fee.

Signed

______

REGISTRATION FORM

ROAD RACING COMPETITION

2° I.P.A. TROPHY VELVET BEACH SENIGALLIA

I.P.A. MEMBER/RELATIVE/FRIENDS: ______

I.P.A. REGION/BRANCH - POLICE FORCE: ______

CITY ______COUNTRY ______

TEL.______FAX______EMAIL______

PLANNED RACES: km 1 children up to 12 years old; km 3 children up to 15 years old; km 5 children up to 18 years old. Adults: 2 courses choice: 1) km 10; 2) km 21. All categories will be divided in male and female.

ATHLETE / male / female / Date of birth / 1 km / 3 km / 5 km / 10 km / 21 km

This form is to be sent to Comitato Esecutivo I.P.A. Senigallia by JULY 30th 2011 through fax 0039 (0)71 7924502 or e-mail: , together with copy of the bank transfer for the registration fee.

N.B. Please indicate the disciplines of interest.

Signed

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REGISTRATION FORM

AMATEUR TOURIST CYCLE

2° I.P.A. TROPHY VELVET BEACH SENIGALLIA

I.P.A. MEMBER/RELATIVE/FRIENDS: ______

I.P.A. REGION/BRANCH - POLICE FORCE: ______

CITY ______COUNTRY______

TEL.______FAX______EMAIL______

ATHLETE / SEX / DATE OF BIRTH

This form is to be sent to Comitato Esecutivo I.P.A. Senigallia by JULY 30th 2011 through fax 0039 (0)71 7924502 or e-mail: , together with copy of the bank transfer for the registration fee.

N.B. The amateur tourist-cycle is not part of the competitions. A souvenir of the event will be given to all participants.

Signed

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