ࡱ> } %bjbj55 ,__ 88!!!'!'!'!8_!4!$'!:h!]"]"]"]"O&&TQ', : : : : : : :$ =?N1:-!( &&@((1:]"]"^:}*}*}*(|"]"!]" :}*( :}*}*n6 r#8]"q''!')^7 9t:0:7h@)v@@#8@!#8}'0'"}*''}'}'}'1:1:)}'}'}':((((@}'}'}'}'}'}'}'}'}'8 E: SOLICITUD INDIVIDUAL PARA LA PARTICIPACIN EN COMPETICIN SIN ADSCRIPCIN A CLUB NOMBREAPELLIDOSD.N.I.DIRECCINC.PCIUDADTELFNACIM.CORREO ELECTRNICO FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FIRMA DEL INTERESADO     FEDERACIN MADRILEA DE SALVAMENTO Y SOCORRISMO CLUSULA DE INFORMACIN Le informamos que sus Datos Personales recabados, van a pasar a formar parte un fichero automatizado propiedad de FEDERACIN MADRILEA DE SALVAMENTO Y SOCORRISMO, como Responsable del Fichero en el que estn insertos los mismos, para la gestin administrativa de la federacin, as como de sus federados. Asimismo, el afectado consiente expresamente, para que sus datos sobre estado de salud, sean tratados por el Responsable, a los efectos antes descritos. FEDERACIN MADRILEA DE SALVAMENTO Y SOCORRISMO se encuentra ubicada en Avenida Salas de los Infantes, 1, Edificio El Barco, 28034 MADRID, direccin a la que se pueden dirigir mediante escrito acompandolo de fotocopia del DNI o documento acreditativo de su identidad, para ejercitar sus derechos de acceso, rectificacin, cancelacin y oposicin. Los datos correspondientes a nombre, apellidos, DNI y club de procedencia, as como los datos de contacto del club (direccin, telfono, mail, pgina web) podrn ser difundidos a travs de la pgina web de la FEDERACIN MADRILEA*:V\r  > @ B D X Z \ Ÿo^Fo/jYh`hXTCJOJQJU^JaJ h`hXTCJOJQJ^JaJ)jh`hXTCJOJQJU^JaJh`hXTCJOJQJhXTCJOJQJh`hXT5CJOJQJ^Jh`hXTOJQJ^Jh`hS0OJQJ^JhXThS05CJ OJQJaJ hF?5CJ OJQJaJ hXT5CJ OJQJaJ hXThXT5CJ OJQJaJ v  @ B j $&`#$/Ifgd$FfT $&`#$/Ifgd7&$&`#$/IfgdS0$$&`#$/Ifa$gdS0$$&`#$/Ifa$gdS0$a$$a$gdXT\ f h j l   ппппппwпп_пп/j9h`hXTCJOJQJU^JaJ/jh`hXTCJOJQJU^JaJ/jIh`hXTCJOJQJU^JaJ/jh`hXTCJOJQJU^JaJ h`hXTCJOJQJ^JaJ)jh`hXTCJOJQJU^JaJ4jh`hXTCJOJQJU^JaJmHnHu! 2 Z $&`#$/Ifgd0Ff$&`#$/IfgdR$&`#$/Ifgd$ " $ . 0 2 4 H J L V X Z \ p r t ~ ҷҦҦҷҦҦvҷҦҦ^ҷҦOh`hXTCJOJQJ^J/jh`hXTCJOJQJU^JaJ/jh`hXTCJOJQJU^JaJ/j)h`hXTCJOJQJU^JaJ h`hXTCJOJQJ^JaJ4jh`hXTCJOJQJU^JaJmHnHu)jh`hXTCJOJQJU^JaJ/jh`hXTCJOJQJU^JaJ        0 B x z | ʼo_R_C?hV(h`hFKCJOJQJaJhFK5CJOJQJaJh`hFK5CJOJQJaJ1jhFK5CJOJQJUaJmHnHsH ujhFKUmHnHuhZjhZUh`h0QOJQJ^Jh`h1OIOJQJ^Jh`hS05OJQJ^Jh`hCJOJQJ^Jh`hXTCJOJQJ^JhXTCJOJQJ^JhCJOJQJ^J     [VVVTTTTT$a$kd $$IfF&\~\1%:: 6`0 ;4 Fayt&#     z | $%%%%%%%%%%%%%%%%$a$#$a$gd&#$a$gd&#$a$gdS0| H R S \   #H$f$$$$$$$$$$%0%g%k%%%%%%%%%%Ҷ}yuhFhZheh&#h&#mH sH hXTCJOJQJaJh h&#CJOJQJaJh$Dh&#CJOJQJaJh&#CJOJQJaJhXTCJOJQJ^JaJUh&#CJOJQJ^JaJ hHh&#CJOJQJ^JaJhHh&#CJOJQJaJ- DE SALVAMENTO Y SOCORRISMO, a los efectos de hacer pblicos los resultados de las competiciones en las que participen el afectado. 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