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Union Internationale de Pentathlon Moderne 2014 UIPM MODERN BIATHLE / TRIATHLE WORLD CHAMPIONSHIPS Men and Women Pacific Naval Command, ESCUINTLA, GUATEMALA 7 th - 12 th October 2014 Asociacion de Pentatlon Moderno de Guatemala ENTRY FORM “A” Please complete using CAPITAL LETTERS and return before 8 th August 2014 COUNTRY: NUMBER OF COMPETITORS: CATEGORIE MODERN BIATHLE MODERN BIATHLE MODERN TRIATHLE MODERN TRIATHLE B + T B + T MIXED RELAY Per team MALE FEMALE MALE FEMALE MALE FEMALE Youth F Youth E Youth D Youth C Youth B Youth A Juniors Seniors Masters A Masters B Masters C Masters D NUMBER OF COACHES/OFFICIALS: _________________ NUMBER OF OTHERS EXTRA: ___________________________________ FEDERATION: ___________________________________ CONTACT PERSON NAME: _________________________________________ For official use only Please return to : GUATEMALAN MODERN PENTATHLON ASSOCIATION 3 Avenida, 16-15 ZONA 15, JARDINES DE MINERVA, GUATEMALA, TEL: +502- 2369-4489 e-mail: [email protected] , website: www.pentatlonmodernoguatemala.com 1
