Registration Form For Leonard Peltier Freedom Run 1996

fungirl869@aol.com
Mon, 11 Mar 1996 16:31:46 -0500


Registration Form For European Participant

Complete and return to the European FREEDOM RUN OFFICE c/o Nitassinan
CSIA, BP 317, F-75229 Paris Cedex 05, France (Fax:
(+33)-1-42413632/e-mail: hdoreau@aw.sgi.com) no later than April 30th,
1996. Each FREEDOM RUN 1996 participant-including runners, Indigenous
delegates and Freedom Run Staff-must complete a registration form:

GENERAL INFORMATION SECTION (PRINT CLEARLY)

Name: ...........................................
Male/Female: ....................................
Age: ............................................
Mailing Address:.................................

City: ...........................................
State: ..........................................
Zip Code: .......................................
Country: ........................................
Nationality: ....................................
Phonenumber: ....................................
Fax: ............................................

e-mail: .........................................................

Emergency phone & contact name: .................................

Organization: ...................................................

FOR RUNNERS ONLY:

Running Experiences: ............................................

Each Runner should be trained to go five kilometers a day at least!

FOR SUPPORT STAFF ONLY:

Check those that apply and, if possible on a separate sheet, list your
qualifications and experience!

Medical Support Staff: ..........................................

Massage Therapist: ..............................................

Interpreter: ....................................................
check the languages: English o
Spanish o
French o
German o
Other o ............................

Cook: ...........................................................

Photographer: ...................................................

Driver with own vehicle:.............kind of vehicle: ...........

Bus-driver: .....................................................

Mechanic with tools: ............................................

Length of time you will be available: ...........................
(be specific noting what dates)

Let this RUN to be a success, spread the word and participate. Please
send the registration form to the above mentioned support group at
Paris/France. If you have problems you can e-mail it
(Wicincala@europeonline.com) to our local support group at Cologne or fax
it (+49)-2241-402093 (fax is working between 6 p.m. to 6 a.m. central
European time) and we will forward it to Paris. For Indigenous persons,
please contact Nitassinan, I don't know of a special other registration
form, or complete this.

In the Spirit,

Birgit
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Indianer Arbeitskreis Koeln
Birgit Spinella
Troisdorf, Germany
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