Inscrição

ASSOCIAÇÃO REGIONAL DE CANOAGEM DA MADEIRA

Avenida Sá Carneiro

Centro Náutico São Lázaro, Hangar 4

9000-017, Funchal

arcm.moc@gmail.com

(+351) 291764330

(+351) 967878694

www.canoagemmadeira.com

NAME (FIRST & LAST)*

GENDER*

LICENCE NUMBER*

CLUB*

NATIONALITY*

MOBILE*

EMAIL*

BIRTH DATE*

DAYMONTHYEAR

COMPETITION YOU WANT TO REGISTER*

MADEIRA OCEAN CHALLENGE (package includes participation in Madeira Surfski Lifesaving)MADEIRA SURFSKI LIFESAVINGTAÇA DE PORTUGAL DE CANOAGEM DE MAR (ADDITIONAL SERVICES ONLY - registration for the competition must be done on the FPC website)TAÇA DE PORTUGAL DE ESPERANÇAS DE MAR (ADDITIONAL SERVICES ONLY, registration for the competition must be done on the FPC website)

THE MADEIRA OCEAN CHALLENGE PACKAGE INCLUDES:

- Sea transportation of Surfski from mainland Portugal to Madeira and back;
- Event T-shirt;
- Closing dinner on both days (October 4th & 5th);
- Souvenirs;
- Surfski and athlete transportation to the start location;
- Registration to participate in Madeira Surfski Lifesaving;
- Prize Money

COST - 70€ per person

AGE LEVEL*

T-SHIRT SIZE

NAME OF YOUR PARTNER (FIRST AND LAST) (SS2 ONLY)

T-SHIRT SIZE OF YOUR PARTNER (SS2 ONLY)

MADEIRA SURFSKI LIFESAVING CATEGORY

THE MADEIRA SURFSKI LIFESAVING PACKAGE INCLUDES:

- Lifesaving Boat;
- Closing Dinner on October 5th;
- Athlete transportation to the start location;
- Prize Money

COST - 10€

CATEGORY*

IF YOU ARE REGISTERED FOR THE TAÇA DE PORTUGAL DE CANOAGEM MAR, YOU CAN HIRE THE FOLLOWING ADDITIONAL SERVICES:*

Sea Transportation of Surfski (45€ per person)Land Transportation of Surfski to the Event from HQ (5€ per person)Transportation of Athlete to the Start Location (5€ per person)Event T-shirt (15€ per person)Participation in Madeira Surfski Lifesaving (Closing dinner, transfer & prize money included) (10€ per person)Closing Dinner on October 5th (25€ per person)

AGE LEVEL*

NAME(S) OF YOUR PARTNER(S) (FIRST AND LAST) (SS2 & OC6 ONLY)

NUMBER OF PEOPLE HIRING THE ADDITIONAL SERVICES*

NOTES

IF YOU ARE REGISTERED FOR THE TAÇA DE PORTUGAL DE ESPERANÇAS DE MAR, YOU CAN HIRE THE FOLLOWING ADDITIONAL SERVICES:*

Sea Transportation of Surfski (45€ per person)

AGE LEVEL

TOTAL COST:

GENERAL CONDITIONS:

IN ORDER FOR YOUR REGISTRATION TO BE VALIDATED, PAYMENT MUST BE DONE TO THE ASSOCIAÇÃO REGIONAL DE CANOAGEM DA MADEIRA:

- BANK TRANSFER IBAN: PT50 0018 000353099826020 08
- BANK TRANSFER BIC/SWIFT: TOTAPTPL
(IDENTIFICATION OF THE NAME WHICH WAS USED IN THIS FORM)

- MBWAY PARA O Nº 967878694
(IDENTIFICATION OF THE NAME WHICH WAS USED IN THIS FORM)

SEND PROOF OF PAYMENT TO arcm.moc@gmail.com

REGISTRATION IS AVAILABLE UNTIL 23/09/2025

BY REGISTERING, YOU ARE AGREEING TO THE GENERAL CONDITIONS AND TERMS SET BY THE ORGANIZING COMITEE OF THE MADEIRA OCEAN CHALLENGE 2025.