Medical Certificate

The   undersigned   M.D. …………………………………………………………………

Address ………………………………………………………………………..

City ……………………………………………………………………………..

Telephone ……………………………………

Certifies that the runner Mr./Mrs ……………………………………..

Date of birth ……./……/……

Has undergone a medical examination permitting him/her to participate in
DOLICHOS ULTRA RACE – 255km – 48h, and is not suffering from any illness
that might cause a prejudice to his/her health while competing.

 

 

                                                 Signature and stamp

 

 

The medical certificate must not be issued prior to 20/3/2026 (2 months before the race)

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