Tour du Nipalou

15320 Lorcières en Margeride
Sunday 29 october 2023
Departure at 8:00 AM for the 53 kms,  9:30 AM for 12 kms, 9:45 AM for the 2.2 kms,

9:50 for the 1.2 kms, 9h55 for the 0.7km 10 AM for the 21 kms and 10:05 AM for the 3.8 kms.

REGISTRATION FORM

To be completed, printed and sent with payment
by cheque to the order of Horizon Nipalou
along with a photocopy of the licence, if applicable, to the following address :
Mr ORLHAC Thierry - 27 rue Alexis Carrel 63000 Clermont-Ferrand
Tel : +33670960828
For accommodation in Lorcières call : +33471239095 ou +33471234979

 Male  Female

 /  /

0,7 kms 1.2 kms 2.2 kms3.8 kms12 kms 21 kms53 kms

 FFA

Non member of the FFA : medical certificate or photocopy dated less than one year mandatory

* Non members of the FFA must be covered by a personal insurance and provide a medical certificate stipulating their physical ability to participate in the competition. This document, original or photocopy dated less than one year, will be kept for a duration of 10 years. Only a medical certificate will be accepted.

Mandatory signature (Athlete or parents for minors)

 

 

To be completed by the organization / Réservé à l'organisation

 

 €

 €

€

€

€

born in or before 2010  €

 €

 €

(+2 € if registration on site) €

 €