ENTRY FORM BMX ST ETIENNE 2018 .pdf


Nom original: ENTRY_FORM_BMX_ST_ETIENNE_2018.pdf

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Saint Etienne (France)
Indoor & Nations Trophy WIAWIS
08/09 december 2018

Entry form
Payment by cash at arrival

Name of association

SWITZERLAND

Country

Entry fees
by rider and by race
Class entered for :
(menu déroulant)

Indoor 20" or 24"
Supercross (13 to 16)
Nations Trophy (17+)

FAMILY NAME

First Name

= 24 euros
= 30 euros
= 62 euros

Thank you for marking "x" in the corresponding classes

Date of birth
(dd/mm/yyyy)

Gender
M/F

Plate #

Indoor

Supercross

Nations Trophy

Entry fees Euros

1

Girls 09/10

CLAESSENS

JADE

21.07.2008

F

73

X

24.00 €

2

Girls 09/10

MANSER

JOY

07.03.2009

F

541

X

24.00 €

3

Girls 09/10

NOËTH

MEREL

04.06.2008

F

306

X

24.00 €

4

Boys 09/10

BELLINO

YOHAN

14.03.2008

M

548

X

24.00 €

5

Boys 09/10

DUBOUX

THOMAS

27.06.2008

M

400

X

24.00 €

6

Boys 09/10

FERREIRA

DAVID

28.07.2008

M

546

X

24.00 €

7

Boys 09/10

GUILHEM

GABRIEL

29.07.2008

M

406

X

24.00 €

8

Boys 09/10

KULLMANN

MAX

07.08.2008

M

502

X

24.00 €

9

Boys 09/10

LEUENBERGER

LORIN

26.07.2009

M

551

X

24.00 €

10 Boys 09/10

MARTIN

ARNO

15.02.2009

M

407

X

24.00 €

11 Boys 09/10

MORET

TIMEO

18.02.2008

M

409

X

24.00 €

12 Boys 09/10

NÜNLIST

SHANE

26.07.2008

M

540

X

24.00 €

13 Boys 09/10

PERRIN

ETHAN

19.05.2008

M

411

X

24.00 €

14 Boys 09/10

POUESSEL

JAMIE

16.03 2009

M

412

X

24.00 €

15 Boys 09/10

RICKLY

LUCAS

31.01.2009

M

549

X

24.00 €

16 Girls 11/12

STIPLOVSEK

JOY

20.11.2007

F

401

X

24.00 €

17 Boys 11/12

COLATRUGLIO

DINO

21.07.2006

M

552

X

24.00 €

18 Boys 11/12

DJANTI

MEHDI

15.01.2007

M

105

X

24.00 €

19 Boys 11/12

GWERDER

BEN

09.10.2006

M

540

X

24.00 €

20 Boys 11/12

HOFER

NICK

11.09.2007

M

541

X

24.00 €

21 Boys 11/12

JORIO

MATIAS

24.01.2007

M

549

X

24.00 €

22 Boys 11/12

LÜTHI

MARK

23.05.2007

M

551

X

24.00 €

23 Boys 11/12

SANTSCHY

KYLIAN

17.11.2007

M

543

X

24.00 €

24 Girls 13/14

CLAESSENS

INÈS

25.05.2005

F

232

X

25 Girls 13/14

MICHAUD

MAGALI

13.09.2004

F

17

X

X

54.00 €

26 Boys 13/14

AKERMANN

KILIEN

12.10.2004

M

308

X

X

54.00 €

27 Boys 13/14

CAMPICHE

SEBASTIEN

10.02.2005

M

8

X

X

54.00 €

28 Boys 13/14

DUBOUX

ROMAIN

24.01.2004

M

300

X

X

54.00 €

29 Boys 13/14

DUSSEX

LUCIEN

03.11.2004

M

550

X

X

54.00 €

30 Boys 13/14

EBENER

MATTEO

18.08.2005

M

310

X

X

54.00 €

31 Boys 13/14

GIMMI

JAMIE

27.02.2005

M

312

X

X

54.00 €

32 Boys 13/14

GRANDJEAN

TANGUY

20.10.2005

M

557

X

X

54.00 €

33 Boys 13/14

GUSTHIOT

LEO

27.02.2004

M

558

X

X

54.00 €

34 Boys 13/14

HOFER

REMO

05.06.2005

M

545

X

X

54.00 €

35 Boys 13/14

HOSTETTLER

NICO

23.01.2005

M

509

X

X

54.00 €

36 Boys 13/14

KASPER

LOUIS

26.09.2004

M

542

X

X

54.00 €

37 Boys 13/14

MARESCUTTI

ALESSIO

05.11.2004

M

790

X

X

54.00 €

38 Boys 13/14

NÜNLIST

SEAL

21.04.2005

M

541

X

X

54.00 €

39 Boys 13/14

SCHILD

FLORIAN

07.10.2004

M

42

X

X

54.00 €

40 Boys 13/14

ZIMMERMANN

IAN

05.05.2004

M

319

X

X

54.00 €

41 Girls 15/16

AEBERHARD

NADINE

28.05.2002

F

1

X

X

54.00 €

42 Girls 15/16

BURFORD

THALYA

25.11.2003

F

659

X

X

54.00 €

43 Girls 15/16

GRANDJEAN

URIELLE

13.10.2003

F

16

X

X

54.00 €

44 Boys 15/16

BOREL

TRISTAN

24.01.2002

M

4

X

X

54.00 €

45 Boys 15/16

CALOZ

TIMO

08.12.2003

M

543

X

X

54.00 €

46 Boys 15/16

CAMPICHE

ARNAUD

20.10.2002

M

556

X

X

54.00 €

47 Boys 15/16

HABERMACHER

ELIA

03.11.2002

M

43

X

48 Boys 15/16

HÜLSDELL

DAVID

08.12.2003

M

563

X

X

54.00 €

49 Boys 15/16

JAKOB

CYRILL

25.04.2002

M

124

X

X

54.00 €

50 Boys 15/16

MICHAUD

JONATHAN

16.12.2002

M

302

X

X

54.00 €

51 Boys 15/16

SCHWAB

LARS

29.09.2002

M

552

X

X

54.00 €

52 Boys 15/16

WEIERSMÜLLER

TIM

30.01.2002

M

546

X

X

54.00 €

53 Boys 15/16

WYRSCH

MAIKEL

22.11.2003

M

307

X

X

54.00 €

54 Women 17+

GRÜNIG

SELINA

02.12.1999

F

119

X

55 Women 17+

MARESCUTTI

LOREDANA

04.02.1999

F

540

X

X

86.00 €

56 Men 17/24

BATAILLARD

QUENTIN

06.07.1994

M

256

X

X

86.00 €

57 Men 17/24

COTTIER

STEVE

20.01.1995

M

744

X

X

86.00 €

58 Men 17/24

CONVERTINI

ANTHONY

12.02.2000

M

546

X

X

86.00 €

ENTRY_FORM_BMX_ST_ETIENNE_2018.xls

24.00 €

24.00 €

24.00 €

Payment by cash at arrival

Name of association

SWITZERLAND

Country

Indoor 20" or 24"
Supercross (13 to 16)
Nations Trophy (17+)

Entry fees
by rider and by race
Class entered for :
(menu déroulant)

FAMILY NAME

First Name

= 24 euros
= 30 euros
= 62 euros

Thank you for marking "x" in the corresponding classes

Date of birth
(dd/mm/yyyy)

Gender
M/F

Plate #

Indoor

Supercross

Nations Trophy

Entry fees Euros

59 Cruiser 40+

CLAESSENS

VINCENT

15.11.1967

M

2

X

24.00 €

60 Cruiser 40+

FÖRSTER

RENE

20.04.1974

M

156

X

24.00 €

61 Cruiser 40+

MURBACH

MARC

18.06.1972

M

74

X

62 Women Elite & Junior

CLAESSENS

ZOE

28.04.2001

F

2

X

X

86.00 €

63 Women Elite & Junior

DONZALLAZ

ELOÏSE

09.06.2000

F

18

X

X

86.00 €

64 Women Elite & Junior

HENRY

LEILA

07.12.2001

F

7

X

X

86.00 €

65 Women Elite & Junior

VON NIEDERHÄUSERN

CHRISTA

31.07.1998

F

62

X

X

86.00 €

66 Men Junior

BURKHARDT

KILIAN

20.06.2000

M

540

X

X

86.00 €

67 Men Junior

BÜRKLER

YANNICK

30.09.2001

M

555

X

X

86.00 €

68 Men Junior

CONVERTINI

FLAVIO

14.02.2000

M

541

X

X

86.00 €

69 Men Junior

KUENZLE

BENOÎT

23.04.2001

M

87

X

X

86.00 €

70 Men Junior

MOSSET

ALEXI

20.04.2001

M

543

X

X

86.00 €

71 Men Junior

SCHUNCK

KEVIN

25.09.2000

M

544

X

X

86.00 €

72 Men Junior

SCHWEIZER

ADRIEN

09.01.2000

M

179

X

X

86.00 €

73 Men Junior

VON NIEDERHÄUSERN

NILS

07.03.2000

M

265

X

X

86.00 €

74 Men Elite

AEBERHARD

LORIS

16.06.1999

M

799

X

X

86.00 €

75 Men Elite

BLANC

RENAUD

03.01.1991

M

373

X

X

86.00 €

76 Men Elite

BRESCHAN

NOAH

11.10.1999

M

343

X

X

86.00 €

77 Men Elite

BRUNNER

GIL

03.04.1999

M

494

X

X

86.00 €

78 Men Elite

CLAESSENS

ARTHUR

31.01.1999

M

767

X

X

86.00 €

79 Men Elite

GRAF

DAVID

08.09.1989

M

7

X

X

86.00 €

80 Men Elite

MARQUART

SIMON

01.11.1996

M

179

X

X

86.00 €

81 Men Elite

RUFENER

RENATO

21.09.1989

M

989

X

X

86.00 €

24.00 €

4 272.00 €

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