2006年西藏国际半程马拉松挑战赛.doc

2006年西藏国际半程马拉松挑战赛 参赛报名表 The Competition Application of “2006 Tibet International Semi-journey Marathon Challenge” 参赛项目 Events □ 半程马拉松 Semi-journey Marathon □ 10公里 10 KM □ 5公里 5 KM 二寸免冠近照 2 inches photo without hat 姓 名 Name 参赛号码 Number 出生年月 Date of Birth 性 别 Sex 国 籍 Nationality 民 族 Race 证件种类 Credentials □身份证 ID Card □护照 Passport　 □户籍簿 Residence Booklet 证件号码 Credentials’ Number 工作单位/职业 Occupation 联系电话 Telephone 家庭住址 Address 邮政编码 Postcode 药物过敏史 Drug Allergy 血 型 Blood Type 比赛经历及最好成绩 Competition Experiences and the Best Results 参赛者声明 我自愿报名参加2006年西藏国际半程马拉松挑战赛。经县级以上医院检查，我的身体健康状况良好，完全符合参赛要求。我接受组委会为本人办理的人身意外险和医疗险。本人若在比赛过程中发生任何伤亡事故以及各项医疗救护费用，均按投保额度向保险公司进行索赔。家属、遗嘱执行人或有关人员均不能状告赛事组委会、赞助商、赛事组委会任命的官员、服务人员、代表、代理机构，以及参与组织、赞助西藏国际半程马拉松挑战赛有关机构、公司及员工，也不向以上单位、个人提出其他索赔要求。同时，我同意组委会有权利使用本人的姓名和肖像进行各项宣传活动。 我声明此报名表所填内容都经我核实，情况属实。 特此声明。 声明人（监护人）签名： 二OO六年 月 日 Statement I apply for 2006 Tibet International Semi-journey Marathon Challenge of my free will. Examined by hospital on county level and above, my physical condition is well, fully according with the demands. I accept the life accident insurance and medical insurance Organizing Committee insured for me. If there are any causalities and expense of medical treatment happened during the competition, it will be claimed an indemnity from insurance company according to the insurance amount. The families, executor and relative persons can not sue the Organizing Committee, sponsors, the officials, servants, representatives, agencies appointed by Organizing Committee, and the relative organizations, companies and staffs participating in the organizing and sponsoring Tibet International Semi-journey Marathon Challenge. Neither could claim other else indemnity from departments and privates mentioned above. At the meanwhile, I agree that Organizing Committee has the right to conduct