个人信息表

个人信息表 附件,1 第五南际半程际拉松比际届宁国 际届宁跑个南解放日际活际人际名表28 thThe 5 Nanning International Half Marathon Individual Entry Form 半程际拉松10公里4公里 Half Marathon10KM4KM 姓名男女出生年月日 NameMaleFemaleDate of Birth 身际份国家/地区 I.D.NumbNationality er 际位地址、际际血型 Company's Address and Postal Blood CodeGroup 家庭住址际系际际际际 Home AddressTel.:Postal Code 最好成际比际名称日期 Best ResultName of EventDate 本人明,声 1、我自愿加第五南际半程际拉松比际际参届宁国28届宁跑并参状南解放日际活际～明白加此际比际际健康 况潜有特殊要求以及在的不安全因素。 2、我自际际格遵守本比际大的所有际定～际加比际已做好充分际际和准际～本人已际际机际～身届会参医构体 体参担并会健康～有能力加此活际。愿意承自身的意外际际际任～无际向大际本人在活际中际生或引致的自身意 外、死亡或任何形式的际失索际或追究际任。 3、本人在此比际中的姓名、照片、像愿意无际提供际大宣际所用。声会 1. I apply to participate in the 5th Nanning International Half Marathon Race & the 28th Nanning Liberation Day Long-distance Race of my own free will, and I am aware of the special requirement for the health condition and potential risks involved in these events. 2. I agree to abide by and follow the rules established by the organizing side, and have made full preparation and training for the race. I have gotten a medical checkup from the medical institution and been proved to be health and capable of participating in these events. I voluntarily assume all the risks occurring during the Event and agree that the organizing side is not responsible for any compensation and liability of the injuries, death or other forms of loss. 3. In relation to the races the organizing side and the designated media are entitled to use my portraits, name, voice and other personal information free of charge for the organizing and popularization of the Event.参际者际名 日期 Signature of Participant : ________________ Date: ____________________ 际际人际名;际者年际不际参18际,, Signature of Guardian (for participants younger than 18 years old) , 际际人身际际际,份号 Guardian’s ID (passport)Number: