WATCH OUT : The runne r has to be born before 1999 , September 06th. To validate definitively your registration, you will have to supply us NECESSARILY A MEDICAL CERTIFICATE dating at least from one year to the date the M é d o c ’ s Marathon 2019. You must send it before June 30th. Since July 2015, the Athletic Licence can not be more accepted such as medical certificate.Tanks type bicycles are forbidden. Only pulled or pushed tanks are allowed.

NO MEDICAL CERTIFICATE = NO BIBTUTTI QUANTI WILL REFUSE TO DELIVER THE BIB WITHOUT THIS DOCUMENT WELL INFORMED

I undersigned Dr _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Certify to have examined this day : D _____ / M _____ / Y_____

Ms / M._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

who has noticed no contraindication to the practice of the Marathon’s race in competition.

Patient’s Date of Bir th : D _____ / M _____ / Y _____

Gender : Female Male

Your T-Shirt’s Size (thanks to circle your choice) : S M L XL XXL

DOCTOR’ S SIGNATURE + STAMP :

MEDICAL CERTIFICATE