SUGLASNOST O SUDJELOVANJU NA UTRCI MALOLJETNE OSOBE Ime i prezime maloljetne osobe: ________________________________________________________________ Datum rođenja: _____________________________________________________________________________ OIB: _______________________________________________________________________________________ Adresa: ____________________________________________________________________________________ Br. licence i UCI Code (ako je izdana): ____________________________________________________________ Ime kluba: __________________________________________________________________________________ Ime i prezime roditelja / staratelja: ______________________________________________________________ Adresa roditelja / staratelja: ___________________________________________________________________ Kontakt telefon / broj mobilnog uređaja staratelja: _________________________________________________ Svi učesnici utrke voze na svoju odgovornost i organizatori ne snose nikakve pravne posljedice u slučaju nezgode ili štete nastale na opremi. Isto tako za djela učesnika prema trećim osobama ili međusobno, organizator ne odgovara. Natjecatelj odnosno roditelj ili druga odgovorna osoba potvrđuje da je upoznat sa propozicijama natjecanja, te prihvaća vožnju na vlastitu odgovornost. Natjecatelj dolazi u pratnji roditelja / staratelja ili druge punoljetne odgovorne osobe. Potpis maloljetne osobe: ______________________________________________________________________ Potpis roditelj / staratelja: ____________________________________________________________________ Potpis predsjednika kluba: _____________________________________________________________________ M.P. Datum:____________________ SUGLASNOST O SUDJELOVANJU NA UTRCI MALOLJETNE OSOBE Name and surname of minor: __________________________________________________________________ Date of birth: _______________________________________________________________________________ Social security number: _______________________________________________________________________ Address: ___________________________________________________________________________________ No. Licence and UCI Code (if issued): ____________________________________________________________ Club name: _________________________________________________________________________________ Name and surname of parents / guardians ________________________________________________________ Parents / Guardians address ___________________________________________________________________ Contact telephone / Cellular phone number: ______________________________________________________ All racers are riding at your own risk and the organizers do not bear any legal consequences in case of accident or damage to equipment. Also for the damage that the participants do to third parties or mutually, the organizer is not responsible. Competitor or a parent or other responsible person confirms that he is familiar with the competition rules, and accepts a ride at your own risk. A competitor comes accompanied by a parent / guardian or other adult person responsible. Minor signature: ____________________________________________________________________________ Parents / Guardians signature: _________________________________________________________________ Club president's signature: ____________________________________________________________________ S.P. Date:____________________
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