{"id":2199,"date":"2026-02-23T21:15:00","date_gmt":"2026-02-23T20:15:00","guid":{"rendered":"http:\/\/polmasters.pl\/?p=2199"},"modified":"2026-02-23T21:06:25","modified_gmt":"2026-02-23T20:06:25","slug":"vii-memorial-j-jasniaka-seniora-puchar-polski-masters","status":"publish","type":"post","link":"https:\/\/polmasters.pl\/?p=2199","title":{"rendered":"X Memoria\u0142 J.Ja\u015bniaka Seniora \/ Puchar Polski Masters"},"content":{"rendered":"\n<div class=\"wp-block-contact-form-7-contact-form-selector\"><div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f216-o1\" lang=\"pl-PL\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fposts%2F2199#wpcf7-f216-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"216\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.5.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f216-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p>Prosz\u0119 zakwalifikowa\u0107 mnie do startu w Pucharze Polski \/ X Memoria\u0142 im. J.Ja\u015bniaka Seniora w podnoszeniu ci\u0119\u017car\u00f3w, kt\u00f3ry odb\u0119dzie si\u0119 w dniach 11.04-12.04 2026 r. w Konstantynowie \u0141\u00f3dzkim. <\/p>\n<p>W zwi\u0105zku z udzia\u0142em w zawodach sk\u0142adam nast\u0119puj\u0105ce o\u015bwiadczenia: <\/p>\n<table>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 1.<\/u><\/b><br \/>\nJa, ni\u017cej podpisany o\u015bwiadczam niniejszym, \u017ce znany jest mi obowi\u0105zek posiadania bada\u0144 lekarskich zezwalaj\u0105cych na udzia\u0142 w zawodach podnoszenia ci\u0119\u017car\u00f3w dla weteran\u00f3w oraz ubezpieczenia zdrowotnego od koszt\u00f3w leczenia.<\/td>\n<td width=\"200px\"><span class=\"wpcf7-form-control-wrap acceptance-901\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-901\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 2.<\/u><\/b><br \/>\nW przypadku braku opinii lekarza, \u017ce nie stwierdza przeciwwskaza\u0144 do udzia\u0142u w zawodach sportowych w podnoszeniu ci\u0119\u017car\u00f3w dla weteran\u00f3w o\u015bwiadczam, \u017ce bior\u0119 udzia\u0142 w zawodach na w\u0142asne ryzyko i odpowiedzialno\u015b\u0107.<\/td>\n<td><span class=\"wpcf7-form-control-wrap acceptance-902\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-902\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 3.<\/u><\/b><br \/>\nW przypadku wyst\u0105pienia kontuzji podczas zawod\u00f3w lub trening\u00f3w przed zawodami o\u015bwiadczam, \u017ce bior\u0119 udzia\u0142 w zawodach na w\u0142asne ryzyko i odpowiedzialno\u015b\u0107. Nie b\u0119d\u0119 ro\u015bci\u0142 pretensji do organizator\u00f3w zawod\u00f3w i personelu pomocniczego, w przypadku wyst\u0105pienia szk\u00f3d cielesnych lub materialnych, z przyczyn niezale\u017cnych od organizator\u00f3w.\n<\/td>\n<td ><span class=\"wpcf7-form-control-wrap acceptance-903\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-903\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 4.<\/u><\/b><br \/>\nJe\u017celi zajdzie konieczno\u015b\u0107 pokrycia koszt\u00f3w leczenia, zakupu lek\u00f3w lub transportu, o\u015bwiadczam, \u017ce ureguluj\u0119 zwi\u0105zane z tym zobowi\u0105zania.\n<\/td>\n<td ><span class=\"wpcf7-form-control-wrap acceptance-904\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-904\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/p>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 5.<\/u><\/b><br \/>\nZobowi\u0105zuj\u0119 si\u0119 do przestrzegania przepis\u00f3w IWF i zarz\u0105dze\u0144 organizator\u00f3w dotycz\u0105cych rozgrywania zawod\u00f3w.<\/td>\n<td ><span class=\"wpcf7-form-control-wrap acceptance-905\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-905\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td width=\"auto\"><b><u>O\u015aWIADCZENIE 6.<\/u><\/b><br \/>\nO\u015bwiadczam, \u017ce przyj\u0105\u0142em powy\u017csze do wiadomo\u015bci.<\/td>\n<td ><span class=\"wpcf7-form-control-wrap acceptance-906\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-906\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<p><!-- <\/table>\n<p> --><\/p>\n<tr>\n<td colspan=\"2\">\n<b>DANE PERSONALNE ZAWODNIKA <span style=\"color:red\"><\/b> <span style=\"color:red\">   <i>(*) - dane wymagane<\/i><\/span><\/p>\n<table style=\"width:450px\">\n<tr>\n<td style=\"border:0px solid;\" width=\"150px\"><label> Nazwisko<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap your-sname\"><input type=\"text\" name=\"your-sname\" value=\"\" size=\"30\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label><\/td>\n<td style=\"border:0px solid;\" ><label> Imi\u0119<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap your-name\"><input type=\"text\" name=\"your-name\" value=\"\" size=\"30\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label><\/td>\n<td style=\"border:0px solid;\" ><label> Data urodzenia <span class=\"wpcf7-form-control-wrap date-594\"><input type=\"date\" name=\"date-594\" value=\"2019-01-01\" class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" min=\"1900-01-01\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/td>\n<td style=\"border:0px solid;\" ><label> P\u0142e\u0107: <span class=\"wpcf7-form-control-wrap menu-332\"><select name=\"menu-332\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"Kobieta\">Kobieta<\/option><option value=\"M\u0119\u017cczyzna\">M\u0119\u017cczyzna<\/option><option value=\"____________\">____________<\/option><\/select><\/span><\/label><\/td>\n<\/tr>\n<tr>\n<td style=\"border:0px;\"><label> Ulica (nr\/m)<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap Ulica\"><input type=\"text\" name=\"Ulica\" value=\"\" size=\"30\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/td>\n<td style=\"border:0px;\"><label> Miasto<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap Miasto\"><input type=\"text\" name=\"Miasto\" value=\"\" size=\"30\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/td>\n<td style=\"border:0px;\"><label> Kod pocztowy<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap KOD\"><input type=\"text\" name=\"KOD\" value=\"\" size=\"10\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/td>\n<\/tr>\n<tr>\n<td style=\"border:0px;\"><label> Adres email<sup>(*)<\/sup> <span class=\"wpcf7-form-control-wrap your-email\"><input type=\"email\" name=\"your-email\" value=\"\" size=\"30\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/label><\/td>\n<td style=\"border:0px;\"><label> Telefon<sup>(*)<\/sup><\/br> <span class=\"wpcf7-form-control-wrap tel-345\"><input type=\"tel\" name=\"tel-345\" value=\"\" size=\"15\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"+48xxxxxxxxx\" \/><\/span> <\/label><\/td>\n<td style=\"border:0px;\"><\/td>\n<td style=\"border:0px;\"><\/td>\n<\/tr>\n<tr>\n<td style=\"border:0px;\"><label> Grupa wiekowa:    <span class=\"wpcf7-form-control-wrap menu-718\"><select name=\"menu-718\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"80+\">80+<\/option><option value=\"75-79\">75-79<\/option><option value=\"70-74\">70-74<\/option><option value=\"65-69\">65-69<\/option><option value=\"60-64\">60-64<\/option><option value=\"55-59\">55-59<\/option><option value=\"50-54\">50-54<\/option><option value=\"45-49\">45-49<\/option><option value=\"40-44\">40-44<\/option><option value=\"35-39\">35-39<\/option><option value=\"30-34\">30-34<\/option><option value=\"_________\">_________<\/option><\/select><\/span> <\/label><\/td>\n<td style=\"border:0px;\"><label> Rozmiar koszulki: <span class=\"wpcf7-form-control-wrap menu-333\"><select name=\"menu-333\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"S\">S<\/option><option value=\"M\">M<\/option><option value=\"L\">L<\/option><option value=\"XL\">XL<\/option><option value=\"XXL\">XXL<\/option><option value=\"XXXL\">XXXL<\/option><option value=\"_______\">_______<\/option><\/select><\/span><\/label><\/td>\n<td style=\"border:0px;\" colspan=\"2\"><label> Deklarowany wynik: <span class=\"wpcf7-form-control-wrap wynik\"><input type=\"text\" name=\"wynik\" value=\"\" size=\"10\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/label><\/td>\n<\/tr>\n<\/table>\n<\/td>\n<\/tr>\n<p><!--<br \/>\n<table> --><\/p>\n<tr>\n<td width=\"auto\">\nWyra\u017cam zgod\u0119 na przetwarzanie moich danych osobowych dla potrzeb statutowych oraz organizacyjnych PFPC Masters, zgodnie z art. 6 ust. 1 lit. a Rozporz\u0105dzenia Parlamentu Europejskiego i Rady (UE) 2016\/679 z dnia 27 kwietnia 2016r.<\/td>\n<td width=\"200px\"><span class=\"wpcf7-form-control-wrap acceptance-800\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-800\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Wyra\u017cam zgod\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td>\nWyra\u017cam zgod\u0119 na otrzymywanie informacji i ofert od PFPC Masters, na adres korespondencyjny, adres e-mail lub telefonicznie na zasadach okre\u015blonych w ustawie z dn.18.07.2002r.\/Dz.U.2002.144.1204\/ o \u015bwiadczeniu us\u0142ug drog\u0105 elektroniczn\u0105.<\/td>\n<td><span class=\"wpcf7-form-control-wrap acceptance-801\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-801\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Wyra\u017cam zgod\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td><b><u>O\u015aWIADCZENIE<\/u><\/b><br \/>\nJa, ni\u017cej podpisany o\u015bwiadczam niniejszym, \u017ce znany jest mi obowi\u0105zek posiadania bada\u0144 lekarskich zezwalaj\u0105cych na udzia\u0142 w zawodach podnoszenia ci\u0119\u017car\u00f3w dla weteran\u00f3w oraz ubezpieczenia zdrowotnego od koszt\u00f3w leczenia.<br \/>\n<br\/>O\u015bwiadczam, \u017ce bior\u0119 udzia\u0142 w zawodach na w\u0142asne ryzyko i odpowiedzialno\u015b\u0107. W przypadku wyst\u0105pienia kontuzji podczas zawod\u00f3w lub trening\u00f3w przed zawodami (z przyczyn niezale\u017cnych od organizator\u00f3w) nie b\u0119d\u0119 ro\u015bci\u0107 pretensji do organizator\u00f3w  zawod\u00f3w i personelu pomocniczego. Ewentualne koszty leczenia, zakupu lek\u00f3w lub transportu, pokryj\u0119 w 100%.<br \/>\n<br\/>Zobowi\u0105zuj\u0119 si\u0119 do przestrzegania przepis\u00f3w IWF i zarz\u0105dze\u0144 organizator\u00f3w dotycz\u0105cych  rozgrywania zawod\u00f3w.<br \/>\n<br\/>O\u015bwiadczam, \u017ce przyj\u0105\u0142em powy\u017csze informacje do wiadomo\u015bci.<\/td>\n<td><span class=\"wpcf7-form-control-wrap acceptance-802\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-802\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Akceptuj\u0119<\/span><\/label><\/span><\/span><\/span><\/td>\n<\/tr>\n<\/table>\n<p><input type=\"submit\" value=\"Wy\u015blij\" class=\"wpcf7-form-control has-spinner wpcf7-submit\" \/><\/p>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":3516,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[11],"tags":[],"_links":{"self":[{"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/posts\/2199"}],"collection":[{"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/polmasters.pl\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2199"}],"version-history":[{"count":22,"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/posts\/2199\/revisions"}],"predecessor-version":[{"id":3517,"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/posts\/2199\/revisions\/3517"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/polmasters.pl\/index.php?rest_route=\/wp\/v2\/media\/3516"}],"wp:attachment":[{"href":"https:\/\/polmasters.pl\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2199"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/polmasters.pl\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2199"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/polmasters.pl\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2199"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}