Registration Form

The registration period to LEITZULIA 2024 will end on Sunday, September 22, 2024 23:00h.
Maximum registration number: 350
Confirmed registrations: 205
Payment pending registrations: 0

Check:

Email address:

Registration fee

INSKRIPZIOA 25.00€

205/350 Participants

Team name

Team name:

= required

Registration data

First Name:

Last Name:

Citizenship:

Identity document:

Birth place:

Gender:

Date of Birth:

Category:

Country of Residence:

Location:

Postal Code:

Province of Residence:

City of residence:

Address of Residence:

Email:

Repeat Email:

Fixed phone:

Mobile phone:

Federated:

License Number:

Runner PLUS Card:

Medical Certificate:

Medical Certificate Validation Time:

Club:

Comments:

Cancellation Insurance:

You never know when you may have an untimely illness, a training injury or any other major unforeseen event that may disrupt your participation in the event.

We offer you the possibility of contracting a cancellation insurance that allows you to recover the amount of the inscription.

The price of the cancellation insurance calculated for your registration is . Please, note that if you do not take it now, you will not be able to do it later.

You can consult the conditions of the insurance here

msgstr "I have read and accepted the port event regulations"

I accept the registration conditions

Administration fee:

Current Registration Price:

Payment summary:

Credit or Debit Card
(Administration fee included)

First Name:
Email address: