Formulir Contest Mascot AFC Asian Cups 2011

Entry Form
for the Mascot Contest of
the AFC Asian Cup Qatar 2011
Participant’s information:
First Name(s)*: ……………………………………………………………………………………………..……....
Last Name(s)*: …………………………………………………………………………………………….……......
Date of birth* (day/month/year): …………...……….…………………………………..…..………….…….......
Address*: ……………………….………………………………… ……..P.O. Box: ……………..………………
Tel. or Mobile nr.*: …………………………………………………........……………………...….….…………...
Fax nr.: .………………………..……………………………………………………………………….…….….…..
Email: …………………….………………………………………………………………………..…………….…..
* mandatory fields
Number of design entry(ies): ………………………… Number of naming entry(ies): …………….…….....
How did you know about the Mascot Contest of the AFC Asian Cup Qatar 2011?
 Internet  Newspaper  School  Others:
Hereby I confirm that I have read and understood the applicable Terms and Conditions of the
Mascot Contest of the AFC Asian Cup Qatar 2011 and that I fully agree with all of them.
Signature:
If the participant is minor or do not have full civil capacity**:
Signature of the legal representative(s):
Place and Date:
**If the participant has not reached the age of 18 (minor) or does not have full civil capacity, the parent(s) or the legal
representative(s) of the participant must sign above on behalf of the participant and indicate their full name and status as legal
representative(s).
Please submit this form duly signed together with your entry(ies) for the Mascot Contest to the following
address until 7th November 2009, 1.00 pm at the latest:
Local Organizing Committee of the AFC Asian Cup Qatar 2011
c/o Qatar Football Association
Marketing department, Olympic Tower, 6th floor
P.O. Box 5333,
Doha - Qatar.
or scanned by e-mail to: mascot@qfa.com.qa
For further information and applicable Terms and Conditions of the present Mascot contest, please visit
the website: www.qfa.com.qa