Ecotrail Funchal - Madeira 2019
PT / Formulário para registo dos antecedentes clínicos dos atletas participantes no Ecotrail Funchal Madeira 2019.
Salientamos que a informação colocada é tratada de forma confidencial e apenas o médico responsável da prova tem acesso à mesma.
Todos os dados serão eliminados após o processamento necessário.

EN / Question form to register health background from the athletes attending to Ecotrail Funchal Madeira 2019.
Please note that the information provided is treated confidentially and only the race doctor has access to it.
All data will be deleted after the necessary processing.

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Nome Completo / Full Name *
Cartão Cidadão / Passport Number *
Contacto telefónico / Phone Number *
Correio electrónico / Email *
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