Second entry

To be returned not later than 25/10/2019

Country : Code :

Address of
National
Table Tennis
Association

NTTA Representative Name

Telephone :  Fax :

Representative e-mail:

Need Need a
Tournament PTT Sex Surname First Name Birthday Classification Team Team Single partner
ID ID Nat (M/F) Class (FamilyName) (GivenName) (dd/mm/yyyy) Points (Y/N) Team ID Event (Y/N) (Y/N) Team Partner (Y/N)

TOTAL Players Staff

NTTA Representative Signature DATE

This FORM must be returned not later than August 25/10/2019 to the following:

by e-mail at:
fatema.presidencia@gmail.com
&
ittfparaevents@gmail.com
 FINAL ENTRY FEE FORM

Country: Code:

Address of
National TT
Association

NTTA President
NTTA Representative
Telephone:
Representative e-mail:

Hotel Nr of participants Prices Total payable

Players DR 550.00 € 0.00 €

Extra night 50.00 € 0.00 €
Players SR 700.00 € 0.00 €
Extra night 100.00 € 0.00 €
Coaches / staff DR 550.00 € 0.00 €
Extra night 50.00 € 0.00 €
Coaches / staff SR 700.00 € 0.00 €
Extra night 100.00 € 0.00 €
Acc classes 1 & 11 DR 450.00 € 0.00 €
Extra night 70.00 € 0.00 €
Entry fee only 280.00 € 0.00 €
Total 0.00 €
Paid with the First entry 0.00 €
Pending to be paid 0.00 €

Bank name: Banco de la Provincia de Buenos Aires

Account name: Federación Argentina de Tenis de Mesa Adaptado

Account number: 00145120001513814

SWIFT CODE: PRBAARBA

IBAN: 01400427 01512005138145

Branch Address: Almafuerte 3086, San Justo, Buenos Aires, Argentina. CP 1754

Specification of payment
Copa Tango + countrey code

**Remember all Bank charges for your account

The payment is to be made not later than 28/10/2019
This FORM must be returned not later than 25/10/2019 to the following:

FATeMA

by e-mail at:
fatema.presidencia@gmail.com & ittfparaevents@gmail.com
Total payable

0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
0.00 €
 TEAM PROFILE FORM

Country : 0 Code : 0

Male or Player or Date of

No Family name Given Name
Female staff Birth
Passport Nr.

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

This FORM must be returned not later than 25/10/2019 to the following:

by e-mail at:
fatema.presidencia@gmail.com & ittfparaevents@gmail.com
 Expiry date

om
 ROOMING LIST

Country : 0 Code : 0
Double rooms
Wheelchair Wheelchair width
No Name of 1st person
(Y/N)
Name of 2nd person Wheelchair (Y/N)
(cm)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

Single rooms
Wheelchair Wheelchair
No Name
(Y/N) width (cm)
1
2
3
4
5
6
7

Double rooms Single rooms Total 0

This FORM must be returned not later than 25/10/2019 to the following:

by e-mail at:
fatema.presidencia@gmail.com & ittfparaevents@gmail.com
Wheelchair width
(cm)
 TRAVEL FORM

Country : 0 Code : 0

Arrival
Arrival Flight/Trai
Date Arriving to Arriving from Surnames of pasangers*
time n No

Flight

Train

Car

NUMBER OF ADDITIONAL WHEELCHAIRS:

For transportation reasons, wheelchair users (class 3-5) sometimes have to or want to sit on car seat (not
sitting in the wheelchair). Please specify if wheelchair users have any requests to be or not to be transfered to
the seat:

Departure
Departure Flight/Trai Departing
Date Departing to Surnames of passengers*
time n No from

Flight

Train

Car

* If your team is arriving/departing with more than one flight, please let us know the
passanger name (especially wheelchair users) as we need to enter it in our logistic database.

This FORM must be returned not later than 5/11/2019 to the following:

by e-mail at:
fatema.presidencia@gmail.com & ittfparaevents@gmail.com
 SPECIAL DIET
(Muslim, Vegetarian..etc)
Country : 0 Code : 0

No Name Diet Remark

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

This FORM must be returned not later than 5/11/2019 to the following:

by e-mail at:
fatema.presidencia@gmail.com & ittfparaevents@gmail.com
 Remark

m
M PLAYER Y
F COACH N
STAFF
OFFICIAL