Piedzīvojums

Atbalsta:

www.celotajs.com

ADVENTURE RACE
VX Latgale 2004



Nolikums		Rules
Pieteikšanās		Application
Starta vieta		Start place
Komandas		Teams
Rezultāti		Results
Foto		Photos

APPLICATION FORM

Please fill and send an application form below!

TEAM NAME:

COUNTRY:

WEBSITE (if you want a link to be put under your teams name):

1. TEAM MEMBER / CAPTAIN Name, surname:

Date of birth (dd.mm.yyyy.):	Gender:
	Female Male
Phone number:

E-mail:

2. TEAM MEMBER Name, surname:

Date of birth (dd.mm.yyyy.):	Gender:
	Female Male
3. TEAM MEMBER Name, surname:

Date of birth (dd.mm.yyyy.):	Gender:
	Female Male
4. TEAM MEMBER Name, surname:

Date of birth (dd.mm.yyyy.):	Gender:
	Female Male

Account info for participation fee:

VX Piedzivojumu Klubs
Adress: Terbatas street 55-23, Riga LV-1001, Latvia
Reg. Nr. 40008083301
Bank: Hansabanka
S.W.I.F.T HABA LV 22
Account: LV20HABA0551007728423

Note: "Team ....... participation fee for VX Latgale 2004"