Registration for the "InterFaith - Marathon" in Luxembourg on 4 June 2011
Surname: First name:
Date of birth (DD.MM.YYYY)
Religion: Gender: m f
Street and number:
Postcode: Location:
Country: Nationality:
Telephone: Mobile: Email:
Participation in: Marathon: Half-Marathon Relay Marathon (legs from 8.3 to 13.3 km)
Expected time:
Date of arrival: Date of departure:
Championchip no (if you have already a chip):
Size of T-Shirt: S M L XL XXL
Remarks:
I will transfer the amount of 42,- € (marathon), 27,- € (half-marathon), 25,- € (relay marathon) to the account of "Evangelische Gemeinde deutscher Sprache in Luxemburg"
IBAN: LU35 0081 6900 4300 1003 BIC : BLUXLULL Reference "InterFaith-Marathon 2011".
Registrations will be accepted until 4 May 2011