MEDICAL CERTIFICATE FOR RUNNERS PARTICIPATING IN ...

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MEDICAL CERTIFICATE FOR RUNNERS PARTICIPATING IN ULTRA ENDURANCE RACES 2016. Medical Certificate of non existence of any contraindication for the practice of Ultra Endurance races of the Catalan Cup detailed below.

ULTRA ENDURANCE RACES As its name states, these races require a high resistance of the runners, taking their body to the limit of the following levels: cardiac, respiratory, muscular, nervous and articular and the use of the energy substrates.

Race

Endurance level Distance (km) + (positive vertical drop (m)/100)

5a Ultra Trail Muntanyes de la Costa Daurada Campionat de Catalunya individual i per equips

169

90Km / +4.500m de desnivell positiu / 2 i 3 d’Abril Unió Excursionista Urgellenca

2a Ultra Estels del Sud 105Km / +5.000m desnivell positiu / 30 d’Abril i 1 de Maig Trail Roquetes Associació Esportiva I Cultural

196

4a Cadí ultra Trail 80Km / +4.600m de desnivell positiu / 18 i 19 de Juny Unió Excursionista Urgellenca

UTVA Ultra Trail Valls d’Àneu - Memorial Edu, Just i Quique 92,3Km / +7.550m de desnivell positiu / 2 i 3 de Juliol Espot Esquí Club Valls d’Àneu

168

243

Ultra Vandekames 100Km / +6.500m de desnivell positiu / 5 i 6 d’Agost Club Centre Excursionista Serres del Mestral

226

Ultra Trail Trepitja Garrotxa Solidària 112Km / +5.400m de desnivell positiu / 22 i 23 d’Octubre Centre Excursionista d’Olot

199

Rambla 41, pral | 08002 Barcelona | tel.: 93 412 07 77 | fax 93 412 63 53 | [email protected] | www.feec.cat

I, Doctor ________________________________________________________________________, with registered office in _________ ___________________________________________________________________, with professional address in _____________ __________________________________________________, contact phone_____________________________ and License number __________________________________

CERTIFY According with the document of “Consens de la Societat Catalana de Medicina de l’Esport (2012); http://www.scme.cat/docs/grups_treball/ConsensRME_SCME_abril_2013.pdf ; After have examined today to Mr. / Mrs. __________________________, with Identity Document number _______________, had been born on the _______________ . And had not noted any medical contra-indication and therefore giving the consideration of QUALIFIED for the participation in the races of the Catalan Cup of Ultra Endurance 2016. Having completed: Medical tests performed to the athletes. To be filled by the doctor.

Comments from the doctor:

DOCTOR’S SIGNATURE AND STAMP

DATE OF ISSUE OF THE MEDICAL CERTIFICATE

Rambla 41, pral | 08002 Barcelona | tel.: 93 412 07 77 | fax 93 412 63 53 | [email protected] | www.feec.cat