Medical Certificate

MEDICAL CERTIFICATE

Name of the event: PARIS ROLLERS MARATHON

Date: 15 Octobre 2017

I, undersigned Doctor …………………………………………………………………………………, graduated in medicine,

certifies that Mr or Mrs ………………………………………………………………………………………………………………,

born the …………../……………../………………… in…………………………………………………………………………………….,

is able to participate in the sport of roller skating in competition.

Made in …………………………………., the …………..……./…………………./…………………..

Signature of the doctor

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Parent category: Medical