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Entry application for SAM 50 km / 35 km / 10 km |
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| September 13, 2008 | |
| Entry application: | SAM 50 km 35 km 10 km |
| Surname: | _____________________________________ |
| First name: | _____________________________________ |
| Year of birth: | ____________ |
| Sex: | M F |
| Address: | _____________________________________ |
| _____________________________________ | |
| _____________________________________ | |
| Country: | _____________________________________ |
| Club / Organization.: | _____________________________________ |
| Phone: | _____________________________________ |
| E-mail: | _____________________________________ |
| Date: | ______________________ |
| Signature: | ______________________ |