ey Un un REGISTRATION FORM Tae Waa Nae TaN [Halt Marathon 21kms Age Group: 18-45 yrs—] 46+ yrs] Dream Run 7 kms Age: 9 Birth Date; Gender: Male [] Female [] Blood Grou Tshirtsze:s [] ME] tO) x.) 2x. [1] Other Nationality: Indian [] Other [J] (Please provide scanned copy of the passport in case of other's) Email: Phone / Mobile: Address: City: Pincode: State: Country: Occupation Contact name & number of family/friend/guardian in case of emergencies (should not be parti in the Event) Person 1: Name. Mobile No. Relation Person 2: Name. Mobile No. Relation Fee: Half Marathon (21 kms.) Dream Run (7 kms.) Rs. 400/- Rs. 200/- Foos Payment Modes: 4. Cash: 2. Cheque / Demand Draft: Expect delays from your courier service andfor bank clearing. Only available for Indian Residents. In favor of “Abhinav Chertiable Trust” payable at Gandhinagar and send it to following address: Run Gandhinagar Run, Narayani Hospital, Opp. S T Bus Stand, Plot No. 1008/2, Sector 7/C, Gandhinagar 382007 Participant Signature: Date of Registration: wenn RECEIPT o Received with thanks from Mr/Ms ‘Sum of Rs. on Stamp & Signature