Silesia Marathon

1 Personal data » 2 Application » 3 Additional data » 4 Registration

Personal data:

*First name:
*Last name:
*Gender:	male female
*Birth date (DD-MM-YYYY):	- -

Address:

*Country:	Poland another country

*Province:
*Post code:	-

*Country name:

*City:
*Street:
*House number:
Flat number:
Cell phone number (for text message containing your finish time):
E-mail:
Please note all entered email addresses will be used for important updates from the event and www site and to remind your password when necessary.

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1 Personal data » 2 Application » 3 Additional data » 4 Registration

Application:

*Distance:	maraton half maraton
Group Affiliation if applicable (Sport Club or Training Team):

Please, check the box, if in the last 2 years in marathon, you've obtained time equal or below 3:10:00. This will provide you a start from first starting zone

Twój wynik w maratonie /z ostatnich dwóch lat/:	hours min. sec.
Miejsce startu tego maratonu:

Otwarte Mistrzostwa Polski studentów i pracowników naukowych

*Typ uczestnika:	Student / studentka Pracownik naukowy
*Nazwa uczelni:
Jestem członkiem AZS

*T-Shirt size:

Please, check the box if you want an accommodation in a gym

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1 Personal data » 2 Application » 3 Additional data » 4 Registration

Masz możliwość zamówienia zindywidualizowanego numeru startowego z własnym opisem. Numer do zawieszenia na plecach. /max 36 znaków/*:

Additional dataIf you want, write here some running or live facts about yourself:Dodatkowe opcje:Medal with your name engraved (additional fee – 30 PLN)
One extra T-Shirt (additional fee – 40 PLN)
Multimedia package – video, photos (additional fee – 40 PLN)
Dodatkowy numer startowy (opłata dodatkowa / dopłata / +6 zł)
Login information:

The login information will be needed for any editing your data in the “My Account”. There you may also check your starting number and payment status.
*Login name:
*Password:
*Retype password:

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1 Personal data » 2 Application » 3 Additional data » 4 Registration

RegistrationI accept the Rules of Silesia Marathon and declare to obey them.*

I hereby give consent for my personal data included in my application to be processed for the purposes of Silesia Marathon, in accordance with the Personal Data Protection Act dated 29.08.1997 (uniform text: Journal of Laws of the Republic of Poland 2002 No 101, item 926 with further amendments)*

I hereby give consent for my image to be used in any photo or video content produced for the purpose of Silesia Marathon organizer.*

I understand that participation in the event is potentially hazardous, and that a registered party should not participate unless they are medically able and properly trained.*
Płatności

do 1 lutego 2012 r. – 30 zł (dla osób urodzonych 3 maja 1947 i wcześniej)
do 1 lutego 2012r. - 60 zł (dla pozostałych osób)
do 15 kwietnia 2012r. - 80 zł
do 27 kwietnia 2012r. - 120 zł
+dodatkowe opłaty wybrane w "dodatkowych opcjach"

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