ÐÏà¡±á>þÿ <>þÿÿÿ9:;ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á€ ø¿DÒbjbjææææ ¢H„Œ„Œú% &ÿÿÿÿÿÿ·vv¹¹ÿÿÿÿ8M4tJKàõõä4ä4ä4JJJJJJJ$*M¢ÌO´³JQè8Œ.Xä4è8è8³J¹¹Kœ=œ=œ=è8´¹¤Jœ=è8Jœ=œ=r…GT]¤…Hÿÿÿÿ Š“``Éœ:jÙGyJK0JKçGž€P;8€P…H€P…Hôä4ô5Âœ=¶6œR7–ä4ä4ä4³J³J>=^ä4ä4ä4JKè8è8è8è8ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ€Pä4ä4ä4ä4ä4ä4ä4ä4ä4v : ATHLETE LOCATION FORM / FORMULAIRE DE LOCALISATION DE L’ATHLETE 2009 THIS FORM MUST BE FILLED IN ON A QUATERLY BASIS / CE FORMULAIRE DOIT ETRE REMPLI CHAQUE 3 MOIS JANUARY – FEBRUARY – MARCH JANVIER –FEVRIER – MARS In this form you must mention every training camp or training course included in the programme of preparation of the wrestler (man and woman) and also the competitions in which he/she will participate. Any change in the training or competition programme must be indicated immediately to FILA and WADA by fax or e-mail (Use the change of information form). Chaque camp d’entraînement ou stage d’entraînement inclus dans le programme de préparation du lutteur ou de la lutteuse doit être mentionné sur ce formulaire ainsi que les compétitions auxquelles il/elle va participer. Tout changement dans le programme de préparation ou dans la participation aux compétitions doit être signalé immédiatement à la FILA et à l’A.M.A par fax ou e-mail (utiliser le formulaire changement d’informations). In order to assist both the FILA and the World Anti-Doping Agency (WADA) with out-of-competition doping controls, you are required to complete this form detailing your whereabouts for 2009. This information is to be forwarded by January 15th 2009 to FILA with copy to the World Anti-doping Agency (WADA) by e-mail or by fax. Pour aider la FILA et l’Agence Mondiale Antidopage (A.M.A) à effectuer les contrôles antidopage, il vous est demandé de compléter le formulaire ci-dessous sur la localisation du lutteur ou de la lutteuse pendant l année 2008. Ce formulaire doit être renvoyé pour le 4 avril 2008 à la FILA avec copie à l Agence Mondiale Antidopage (A.M.A) par e-mail ou par fax : FILA ( ð ðfax no : (+41)21 323 60 73 WADA ( ðfax no : (+1) 514 904 87 60 ( ðe-mail : carlos@fila-wrestling.com (e-mail :Kenza.Bouhaddi@wada-ama.org e-mail : whereabouts@wada-ama.org Please type or print legibly in block letters, in French or English and be as accurate and thorough as possible/ SVP remplir par ordinateur ou écrire en majuscules, en français ou en anglais, les renseignements de la façon la plus exacte et précise possible NAME/NOM: SURNAME /NOM DE FAMILLE FIRST NAME/PRENOM ATHLETE FILA LICENCE CARD NUMBER/ NUMERO DE CARTE LICENCE FILA: 3. DATE OF BIRTH/DATE DE NAISSANCE: DAY-JOUR MONTH-MOIS YEAR-ANNEE 4. WRESTLING STYLE/ STYLE DE LUTTE : 5. SEX: Male/Homme ( Female/Femme ( 6. NATIONALITY/ NATIONALITE: 8 8. ð TRAINING LOCATION/CENTRE D ENTRAINEMENT FACILITY NAME/NOM DU CENTRE: FACILITY ADDRESS/ ADRESSE DU CENTRE: START DATE OF TRAINING /DATE COMMENCEMENT DE L ENTRAINEMENT: END DATE OF TRAINING/ DATE FIN ENTRAINEMENT: MONTH / MOIS : DAILY SCHEDULE (INSERT TIMES)/ HORAIRE PAR JOUR (METTRE LES HEURES EXACTES) MONTH / MOIS : WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDIWEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI MONTH / MOIS : WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDIWEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDIWEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI 9. Training Camps/ Camps d’entraînement 1st Training Camp/ 1er Stage d’Entraînement : Training Camp name/nom du camp d’entraînement : Training Camp address/ adresse du camp d’entraînement : (insert full address/adresse complète) Name and Position of contact person at venue/nom et fonction de la personne à contacter sur place : Contact person telephone number/numéro de téléphone de la personne de contact ci-dessus: MONTH / MOIS : DAILY SCHEDULE (INSERT TIMES)/ HORAIRE PAR JOUR (METTRE LES HEURES EXACTES) WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates: SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDIWEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI 2nd Training Camp/ 2ème Stage d’Entraînement : Training Camp name/nom du camp d’entraînement : Training Camp address/ adresse du camp d’entraînement : (insert full address/adresse complète) Name and Position of contact person at venue/nom et fonction de la personne à contacter sur place : Contact person telephone number/numéro de téléphone de la personne de contact ci-dessus: DAILY SCHEDULE (INSERT TIMES)/ HORAIRE PAR JOUR (METTRE LES HEURES EXACTES) WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI WEEK/SEMAINE Dates:SUNDAY/ DIMANCHEMONDAY/LUNDITUESDAY/ MARDIWEDNESDAY/ MERCREDITHURSDAY/ JEUDIFRIDAY/ VENDREDISATURDAY/ SAMEDIAM/MATINPM/APRES-MIDI Accommodation name/nom de l’hébergement : (name of athletes’ accommodation venue) (nom de l’endroit ou est loge l’athlete) Accommodation address/adresse de l’hébergement : (give the full address of the above-DONNER L’ADRESSE COMPLETE) Date and time of athlete arrival/ Date et heure d’arrivée de l’athlète Date and time of athlete departure/ Date et heure de départ de l’athlète 10. Competition schedule and details/ programme de compétitions de l’athlète et informations NAME and PLACE OF THE COMPETITION/ nom ET LIEU de la competition TEL FAX START DATE/ DEBUT END DATE / FIN NAME AND PLACE OF THE COMPETITION/ nom ET LIEU de la competition : TEL FAX START DATE/ DEBUT END DATE / FIN Name(IN BLOCK LETTERS), position, telephone of person completing form/ Nom (EN MAJUSCULES), fonction et téléphone de la personne ayant complété ce formulaire : SIGNATURE : I acknowledge that the information mentioned of this form may be shared with the World Anti-Doping Agency and other relevant authorities as specified in the World Anti-Doping Code on the condition that the information be used for doping control purposes only. Je suis d’accord pour que les informations ci-dessus soient partagées avec l’Agence Mondiale Antidopage ou d’autres autorités comme spécifié dans le Code Mondial Antidopage à la condition que ces informations soient utilisées seulement pour faciliter les contrôles antidopage. I recognize that failure to provide accurate and adequate information on time may result in investigation and sanctions imposed to me or possibly my National Federation by my governing body of sport, the FILA. Je reconnais qu’en cas de fourniture d’informations inexactes ou erronées ou non fourniture d’informations, la FILA fera une enquête et l’athlète et éventuellement sa Fédération seront sanctionnés. ONLY ONE WRESTLER INCLUDED IN THE REGISTERED TESTING POOL MUST BE MENTIONED ON EACH FORM YOU FILLED IN / UN SEUL LUTTEUR-CIBLE DOIT ETRE MENTIONNE SUR CHAQUE FORMULAIRE REMPLI - PAGE 4 - 7. 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