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Osteo 43
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Volcano Free/Discount entry form 2018
First Name - Nombre
Address Line 1 - DIrección 1
Postcode - Código postal
Country - País
Phone Number - Número de teléfono
Date of Birth - Fecha de nacimiento
Emergency Contact Name - Nombre contacto emergencia
Occupation - Ocupación
Gender - Género
Male
Female
Canary Island Resident - Residente en las Islas Canarias
Yes
No
Are you staying at Club La Santa? Está alojado en Club La Santa?
Yes
No
Are you a previous finisher of this event? - Fuiste finisher en este evento?
Yes
No
Do you have any current or re-current medical conditions? - Tiene alguna condición médica actual o recurrente?
Yes
No
Do you have any allergies or adverse reaction to any medication? - Sufre de alguna alergia o una reacción adversa a algún medicamento?
Yes
No
Are you diabetic? - Eres diabético?
Yes
No
Last Name - Apellidos
Address Line 2 - Dirección 2
City - Ciudad
Nationality - Nacionalidad
Email - Correo electrónico
Passport/ID Number - Pasaporte o DNI
Emergency Contact Number - Tel. contacto emergencia
Club Name - Nombre del Club
How did you hear about this event? - Cómo te enteraste de este evento?
Comments - Comentarios
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