Athlete Location Form
The following form is being collated for the purpose of doping control. All athletes competing under the jurisdiction of UIPM are required to complete the following form and return to UIPM whenever any of the listed details change. If any temporary changes occur please use the “Temporary Athlete Location Form” attached.
Athlete’s Personal Details
Surname: ______________________ First Name: __________________________ Country Competing For: ________________________________________________ Gender: M F Date of Birth (day / month / year): ________________
Residential Address: __________________________________________________ ________________________ Country:_________________ Postcode: __________ Phone Number: (country code / area code / number): _________________________
Training Details
Venue 1 Training Address: ____________________________________________
_________________________ Country:_________________ Postcode: _________ Phone Number: (country code / area code / number): _________________________ Venue 1 Training Schedule Day Mon Tues AM PM Wed Thurs Fri Sat Sun
Venue 2 Training Address:
____________________________________________
_________________________ Country:_________________ Postcode: _________ Phone Number: (country code / area code / number): _________________________ Venue 2 Training Schedule Day Mon Tues AM PM Wed Thurs Fri Sat Sun
Person Responsible for whereabouts submission to ADAMS
Details of person who will be inputting into ADAMS the changes to the whereabouts information for this athlete : Surname: ______________________ First Name: __________________________ Organisation (if not the athlete) : _________________________________________ Position within Organisation: ____________________________________________ Phone Number: (country code / area code / number): _________________________ Fax number: _________________________ email: _________________________
Union International de Pentathlon Moderne (UIPM) - Stade Louis II - Entrance E, 13 Avenue des Castelans, MC-98000 Monaco Tel. +377 9777 8555, Fax +377 9777 8550, email – uipm@pentathlon.org