5-th Mountain Bike Orienteering World Championship

PRELIMINARY ENTRY FORM

To be filled IN BLOCK CAPITALS by Country Federations.
Must be submitted till April 30th, 2007 to WOC MTBO 2007 office:
Czech orienteering federation, Zatopkova 100/2, 160 17  Praha 6, Czech republic
or by e-mail: csob@cstv.cz

Country:						

Team details:	WOMEN
(max. 8)	MEN
(max. 8)	OFFICIALS	TOTAL	
Number of participants:					

	WOMEN
(max. 2)	MEN
(max. 2)	
Number of relay teams:			

Accomodation:
We wish to book the following standard categories:
	TOTAL PERSONS		PRICE/ PERSON	TOTAL PRICE	
CATEGORY A		x	385 EUR		
CATEGORY B1		x	210 EUR		
CATEGORY B2		x	175 EUR		
CATEGORY C		x	140 EUR		

Entry fee:
	TOTAL PERSONS		PRICE/ PERSON	TOTAL PRICE	
Entry fee (all participants = competitors + officials)		x	50 EUR		
Sprint		x	40 EUR		
Short distance		x	40 EUR		
Long distance		x	70 EUR		
Relay (per teams)		x	150 EUR		

Payments have to be carried out by May 31th 2007 by means of:
Beneficiary: Český svaz orientačního běhu, Zátopkova 100/2, 160 17 Praha 6
Beneficiary s Account No.: CZ7606000000001716809504
Beneficiary s Bank: GE Money Bank, Vítězné náměstí 2, 160 00 Praha 6
Bank Identification Code: AGBACZPP
All bank fees must be paid by the sender. Entries will not be valid until we receive the full payment.

Transport:
We need transport to/from the Event Centre or we use own transport:
from/to requirements	Arrival	Departure	
	Date	Time	Total persons	Date	Time	Total persons	

We use own transport
to and from the Event Centre							

Team manager:

Name:		Phone:		

Address:		

Fax:		E-mail:		

Date:		Signature: