15th European Heart and Lung Transplant Games Vilnius 2014
Registration form Participant
Personal data
Mr.
Mrs.
Miss.
Name ________________________________ First name ____________________________________
Date of Birth (dd/mm/yy): __/__/__
Country _______________________________ Town ____________________________
Address ________________________________________ Post Code _______________
Telephone ______________________________ Email ___________________________
Heart transplant recipient
Lung transplant recipient
Transplant recipient participating in the games: Yes
T-shirt size: S
M
Team manager
L
XL
Heart- and lung transplant recipient
No
XXL
Other _________________
Name of Association ________________________________________________
Any Special Diet: None
Vegetarian
Other _______________________________________
Contact person in case of emergency: Name ________________________________________________
Telephone _______________________
Transport (arrival & departure)
By plane
By car
Other ___________________
Arrival date: __/__/__ __:__ Departure date: __/__/__ __:__
Arrival time: __/__/__ __:__
Departure time: __/__/__ __:__
(Flight number): _________ (Flight number): ________________
Number of days: _________
Hotel accommodation
Double room
Infirm
Twin room
Single room
No accommodation needed
Special care for disabled (wheelchair)
I wish to share a room with: Mr.
First name: ____________________
Mrs.
Name: ______________
Country ______________
Sport
Golf
Golf training (€45)
Golf buggy hire(2 seats) (€12 per seat)
Golf clubs (€25)
License number:………………………………………..
Handicap:…………………………………………………….
Cycling
Using own cycle
Cycle to be provided by Vilnius €15
Cross Country
Biathlon
(combination between 20km cycling and 1500m (male) and 800m (female))
Volleyball
Table tennis (single)
Table tennis (double)
Partner:……………………………………………………………………..
Tennis (single)
Tennis (double)
Partner:……………………………………………………………………….
Badminton (single)
Badminton (double)
Partner:……………………………………………………………………….
Petanque
Partner 1:……………………………………………………………………………………………………………………
Partner 2:……………………………………………………………………………………………………………………
Athletics
High jump
100m
Long jump
400m
Shot put
800m (female)
Ball throw
1500m (male)
4x 100m relay
Swimming
50m backstroke
100m backstroke
50m freestyle
100m freestyle
50m breaststroke
100m breaststroke
4x 50m relay
Excursions
Excursion Vilnius by foot
Sunday 9:00
Monday 17:00
Excursion Vilnius by bus
Sunday 16:00
Monday 16:00
Excursion to Trakai
Sunday 9:00
Tuesday 9:00
Tour to Aukstaitija
Thursday 17th, 7:00
Thursday 17 , 6:00
On my excursions I wish a
English
French
German
Overview costs
Participation and accommodation (5 nights: from 12th to 17th )
Participants and supporters with accommodation
€ 530
(>18 years)
Participants with accommodation (<18 years)
€270
Supporters with accommodation (<18 years)
€270
Participants and supporters without
€350
accommodation
Accommodation in single room
€600
Sports
Golf training
Golf clubs hire
€45
€25
Golf buggy hire (2 seats)
Bike + helmet (not more thna 15 bikes)
€12 per seat
€15
Excursions
Total cost ______
Cost: € 18
Cost: € 35
Cost: €75
guide that speaks
A walk around Old Vilnius
A 3 – hour Old Vilnius bus tour
A tour of Vilnius Old Town and Trakai
A tour to Aukštaitija
A tour to the Curonian Spit
Cost: € 15
Cost: € 50
th
Tour to Curonian Spit
Wednesday 9:00
€15
€18
€35
€50
€75
Terms and Conditions
The terms and conditions are applicable to all (sport) activities and excursions organized for the European
Games for Heart and Lung Transplant recipients by the organization of Vilnius 2014.
1. Registration/Participation
1.1 Individuals who wish participate in these Games need to register by completing online registration
forms for Vilnius 2014.
1.2 The person who registers (hereafter called ‘participants’ or ‘supporter’) agrees that his/her data can be
stored in the administration database of the Vilnius Foundation 2014, and for this contact data to be
used.
2. Sports
2.1 All sporting equipment must be provided by participants, unless the organizers should instruct
otherwise.
2.2 Wearing a helmet is always required for cyclists.
2.3 For more details, see the complete Rules and Regulations 2011 of the EHLTF.
3. Payments
3.1 Members (and staff) of the national heart- and lung transplant associations belonging to the European
Heart and Lung Transplant Federation (EHLTF) should make the payment through the national
association.
3.2 Individual participants and their supporters (family, children and staff) who are not members of the
EHLTF must pay directly to the GYVASTIS.
4. Cancellation
If you intend to participate in the European Games Vilnius 2014 you are advised to buy cancellation
insurance.
4.1 Any notice of cancellation must be made in a writing letter with reasons to: info@vilnius2014.lt A
service charge of € 20,- will be charged if cancellation is before June 1, 2014.
4.2 If cancellation occurs between June 1, 2014 through to June 28, 2014 there is 65% participation cost due
to the Foundation Vilnius 2014.
4.3 If you cancel after June 29, 2014, the entire participation fee will be charged.
5. Liability
5.1 Foundation Vilnius 2014 is not liable for damage, exchange, abandonment, loss and / or theft of personal
property in connection with the stay and use of accommodations and related facilities.
5.2 The use of sports facilities and associated facilities of the participant is at their own risk. Foundation
Vilnius 2014 is not liable for (physical) damage to the participant of any kind therefore, whether during
or in connection with the use of sports facilities, related facilities or materials made available.
5.3 Registration closes on 1 April 2014.
5.4 It is possible until May 1, 2014 to make changes to your sport choice.
6. Safety and house rules
6.1 The participants will be aware of the risks of the sports.
6.2 The participants must abide by the house rules of the hired sports centers. These house rules are
published at the entrance of the property.
I hereby agree with the terms and conditions of the European Games Vilnius 2014
Name _______________________________________Place _________________________________________
Date _________________________________________ Signature _____________________________________