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Preliminary registration form for the Cadets_ Juniors _ Seniors CSIT

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					  Preliminary registration form for the Cadets, Juniors &
           Seniors CSIT Championships Karate
The Union      : ____________________ Country           : __________________________
confirms its participation to the Cadets, Juniors & Seniors CSIT Championships Karate which
will be held in Lignano Sabbiadoro - Italy from 17 till 23 June 2012..
The delegation will comprise:
_______ Women / Girls           __________ Men / Boys
_______ Coach                   __________ Referee(s)     _______ Head of the Delegation
Total : _______________ (Maximum twentyfive (25) persons)


The delegation will travel by train / plane / bus. Airport of destination: …………………….
Foreseen date of arrival ___/___/2012; foreseen date of departure ___/___/2012.
Our Karate-contact person / address is:
Name: _____________________ Address: ________________________________________
Zip code / City: ___________________ Phone : _______________ Fax: ________________
e-mail: _______________________           Signature authorised person:
Please note:
This form is to be returned to the organiser AICS and the TC Karate not later than 30 April
2012. All further information will be sent to your union and the Karate contact person.
Your remarks please:     _______________________________________________________
Please send this preliminary registration form back to:
The organiser AICS                              The TC Karate of the CSIT
Via Barberini 68                                the chairman Mr. Henk Bouchoms
00187 Rome – Italy                              Meeuwenlaan 41, 1021 HS AMSTERDAM
Phone: (+)39/6/42039434                         the Netherlands
Fax: (+)39/6/42039421                           Phone: (+)31 20 63 63 061
e-mail: dnsport@aics.info                       Fax:    (+)31 20 63 63 466
                                                e-mail: ncs@sport4all.nl / bouchoms@planet.nl

				
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