/ 4 - 11 August 2014
Munich, Germany

Entry Form World Championship 2014

______

For participation in the IWAS World Championship 2014 this completed form shall be returned by the national member organisation of the IWAS to the IWAS () by email, stamped and signed, by 4 January 2014 latest, with cc to the Organising Committee () !

Name IWAS Member
Organisation: / Stamp
Contact Person:
Postal Address:
Place and Nation:
Email address:
Telephone number: / Signature:
Fax:

Please note

  • Nations may apply to participate with one Team Delegation.
  • Nations may apply Classifiers for the ICEWH Classifiers Course.
  • Nations shall be registered and accepted after the Organizing Committee has received the completed Entry Form and 30% payment by 4 January 2014 latest.
  • Participation will not be accepted after this closing date.
  • For more information: see Entry Information “WORLD CHAMPIONSHIP 2014” or email to the Organising Committee secretariat.

Organizing Committee Secretariat

Contact Person:Julian Wendel

E-mail:, with CC to .

Phone number:+49 (0)931 68545

Postal address:OK E-Hockey WM 2014, c/o TSV Forstenried, z. Hd. Christa Sieber, Graubündener Str. 100

Code & Place: 81475 München

Nation: Germany

Website:

Participation Fee

The Participation Fee of € 700 per member of the Team Delegation shall be transferred as follows:

- 30% = € 210 per person by 4 January 2014 latest

- 70% = € 490 per person by 1 May 2014 latest

(The total amount for 4 January 2014 shall be counted as follows: the expected number of persons of the Team Delegation as mentioned in this form X € 210).

The Participation Fee for participants of the Classifiers Course is: € 500

This amount shall be transferred by 1 May 2014 latest.

Name and place of accountholder
Name: Deutscher Behindertensportverband e.V.
-Im Hause der Gold-Kraemer-Stiftung-
Tulpenweg 2-4
50226 Frechen
Account number: 1931 455 644 / Name and address of bank
Bank: Sparkasse KölnBonn
Bank Address: Hahnenstraße 57
50667 Köln
IBAN: DE40 3705 0198 1931 4556 44
BIC/SWIFT: COLSDE33XXX
DESCRIPTION: EWH World Championship 2014 – >Nation<
Team Delegation

Nations participating are entitled to use a maximum of 26 members per Team Delegation. Regulations:

  • Max. 1 Team Manager (if wheelchair user max. 1 Personal Assistant is allowed).
  • Max. 2 Coaches (if wheelchair user(s) max. 1 Personal Assistant per coach is allowed).
  • Max. 10 Athletes with max. 10 Staff Members (including Medical Staff, Technical Staff and

Team Assistants).

TEAM MANAGER
Name
Email address
Gender (male / female)
Wheelchair user? (yes/no)
Will bring Personal Assistant? (yes/no)
NATIONAL COACH
Name
Wheelchair user? (yes/no)
Will bring Personal Assistant? (yes/no)
ASSISTANT COACH
Name
Wheelchair user? (yes/no)
Will bring Personal Assistant? (yes/no)
Expected number of Athletes (max. 10):
Expected number of Team Assistants (max. 10, excl. Team Manager, Coach(es) and their Personal Assistants):
Total number of expected members of the Team Delegation:
(max. 26: number of Athletes + number of Team Assistants + Team Manager, Coach(es) and their Personal Assistants):
Expected way of travel (aeroplane, train, bus, car):

Course Classifiers

Please mention the name(s) and data of the expected Course Classifier(s) who enrol for the Classifiers Course.

A Course Classifier shall be a (para)medical person (doctor, physiotherapist) or an EWH technical person,

who wish to become an official ICEWH Classifier, able to control and observe the Players Eligibility and

Classification of participating athletes by medical information and the ICEWH Minimum Disabilities.

Basic knowledge of medical diagnoses, physical and / or sports functional knowledge is required.

In case more than two Classifier form your nation wish to enter the course, please copy this page.

Please note that the Classifiers Course starts one day earlier (on Sunday 3 August 2014) than the event programme for the teams.

Please add the Curriculum Vitae of the Course Classifiers to this Entry Form.

Course CLASSIFIER / (Please fill in here)
Name
Postal Address
Code & Place
Nation
Email address
Telephone number
Date of Birth
Gender / Male/Female
Size of clothes / S/M/L/XL/XXL
Wheelchair user? / Yes / No ?
Will bring Personal Assistant? / Yes / No ?
(Para) medical function (doctor, physiotherapist, etc.)
Speaking English? / Yes / No ?
Expected way of travel (aeroplane, bus, car)
Course CLASSIFIER / (Please fill in here)
Name
Postal Address
Code & Place
Nation
Email address
Telephone number
Date of Birth
Gender / Male/Female
Size of clothes / S/M/L/XL/XXL
Wheelchair user? / Yes / No ?
Will bring Personal Assistant? / Yes / No ?
(Para) medical function (doctor, physiotherapist, etc.)
Speaking English? / Yes / No ?
Expected way of travel (aeroplane, bus, car)