Your Name and Surname (required)

ID / Passport Number (required)

Date of Birth (required)

Gender (required)
MaleFemale

Your Email (required)

Your Mobile Number (required)

Club

Next of Kin Name (required)

Next of Kin Mobile (required)

Bib Number (if you have any)

Participation fee.

Adidas 'Terrex' V19K ( VictoriaLines) - €40
All those applying for the whole series will receive a gift (not necessarily a t-shirt).
T-shirt size (required)
XSSMLXL
On acceptance of this entry, I, the undersigned, intend to be legally bound, hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims I may have against the organisers, sponsors or official suppliers for any loss, damage or injury I may sustain as a consequence of my participation in any activities organised by Agones Sfc. I declare that I will abide by the eligibility rules and competition rules. I also declare that I have trained sufficiently for the event and that my physical condition has been monitored by a medical doctor. I hereby declare that the above particulars are COMPLETE and CORRECT in every detail.
I understand that in case of postponement, the event is non refundable.
I give permission for the photos to be uploaded on social media
I accept all term and conditions stated above.
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