Thailandmarathon.org - Info and links to marathons and running events in Thailand

Laguna Phuket Triathlon
Team Relay Registration

Registration	01 April 08 - 31 October 08
Team Relay	THB 10,500.-
Awards Banquet Ticket 1 Entry 3 Tickets maximum	01 April 08 - 31 October 08
Adult	THB 1,200.- per person

ONLINE REGISTRATION FORM ( Fields marked with * are required )

Entry Date :
Yellow Chip Code :
	Please fill in your yellow chip code if you have one. If not, put ( - ) in this field. We will provide you with a chip for the race.
Farewell Party Ticket :	* = THB
Total Amount :	THB
* Team Name :
* Captain's Given Name :
* Captain's Family Name :
*E-mail (First priority) :
*Confirm E-mail (First priority) :
Second E-mail :
"Please provide full and accurate address details as the organizers might need this for mailing your certificate"
* Address :
* City:
* State/Province:
*Country of Residence :
* Zip-Code :

SWIMMER
* Swimmer's Name :
* Nationality :
* Gender :
* Date Of Birth :	- - (dd - mm - yyyy)
* Age :	(Age on 7 December 2008)
* T-Shirt Size :
* Address1 :
Address2 :
Suburb :
State / Province :
* Postal Code :
*Country of Residence :
* E-mail :
* Business Phone :
* Direct Line :
Private Phone :
* Mobile :
Facsimile :
* Occupation :
* Emergency Contact Person 1 :
* Emergency Contact Telephone 1 :
Emergency Contact Person 2 :
Emergency Contact Telephone 2 :
Overseas Airline :
Hotel in Phuket :
Domestic Airline :
Significant Athletic Accomplishments or Interesting personal story associated with the event :
Does swimmer have any current medical problems or conditions which a doctor is treating ? Details :	Yes No
Is swimmer allergic to any medications? Details :	Yes No
Does swimmer wish the event medical staff to be aware of any specific medical problem ? Details :	Yes No
Medical treatment in last 12 months Details :	Yes No
As a Swimmer, I certify that I am medically fit to complete and fully understand that I enter at my own risk, and the organizers will in no way be held responsible for any injury, illness of loss, during or as a result of the event.
CYCLIST
* Cyclist's Name :
* Nationality :
* Gender :
* Date Of Birth :	- - (dd - mm - yyyy)
* Age :	(Age on 7 December 2008)
* T-Shirt Size :
* Address 1 :
Address 2 :
Suburb :
State / Province :
* Postal Code :
*Country of Residence :
* E-mail :
* Business Phone :
* Direct Line :
Private Phone :
* Mobile :
Facsimile :
* Occupation :
* Emergency Contact Person 1 :
* Emergency Contact Telephone 1 :
Emergency Contact Person 2 :
Emergency Contact Telephone 2 :
Overseas Airline :
Hotel in Phuket :
Domestic Airline :
Significant Athletic Accomplishments or Interesting personal story associated with the event :
Does cyclist have any current medical problems or conditions which a doctor is treating ? Details :	Yes No
Is cyclist allergic to any medications ? Details :	Yes No
Does cyclist wish the event medical staff to be aware of any specific medical problem ? Details :	Yes No
Medical treatment in last 12 months Details :	Yes No
As a Cyclist, I certify that I am medically fit to complete and fully understand that I enter at my own risk, and the organizers will in no way be held responsible for any injury, illness of loss, during or as a result of the event.
RUNNER
* Runner's Name :
* Nationality :
* Gender :
* Date Of Birth :	- - (dd - mm - yyyy)
* Age :	(Age on 7 December 2008)
* T-Shirt Size :
* Address 1 :
Address 2 :
Suburb :
State / Province :
* Postal Code :
*Country of Residence :
* E-mail :
* Business Phone :
* Direct Line :
Private Phone :
* Mobile :
Facsimile :
* Occupation :
* Emergency Contact Person 1 :
* Emergency Contact Telephone 1 :
Emergency Contact Person 2 :
Emergency Contact Telephone 2 :
Overseas Airline :
Hotel in Phuket :
Domestic Airline :
Significant Athletic Accomplishments or Interesting personal story associated with the event :
Does runner have any current medical problems or conditions which a doctor is treating ? Details :	Yes No
Is runner allergic to any medications ? Details :	Yes No
Does runner wish the event medical staff to be aware of any specific medical problem ? Details :	Yes No
Medical treatment in last 12 months Details :	Yes No
As a Runner, I certify that I am medically fit to complete and fully understand that I enter at my own risk, and the organizers will in no way be held responsible for any injury, illness of loss, during or as a result of the event.
Remarks :



(Before you register for the race, please read Race Rules)