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Declaration Athlete licenced or registered for a Foreign Federation

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Declaration

Athlete licenced or registered for a Foreign Federation

Name ………..Surname/Family Name………...

Born in……… on (dd-mm-yyyy)………

Nationality………Sex: M F Address………..

Country……….

Declares that

is registered for or licenced by the following IAAF Federation:

Federation Name………

Club/Team (if applicable) ……….

Card number/code ………

I hereby declare myself fully responsible for this declaration, acknowledging the legal consequences of a false statement.

Signature………..

Date………...

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