Laguna Phuket International Marathon™
Race Registration

(Please Confirm Your Information!)

Please note that THIS IS NOT A CONFIRMATION OF YOUR REGISTRATION

To receive an official confirmation, please kindly do as follows:

  • Recheck your submitted information below, if something is not correct, click back on a browser tool bar to correct
    your information
  • If your information is all correct, please click at the bottom of the page "PAY VIA SECURE SERVER" to pay
    for your entry with a credit card.

IMPORTANT REMARKS

  • Please make sure that you provide all relevant information
  • We only accept online payment through VISA, MasterCard or JCB
  • The fee for the race is non-refundable!
  • Make sure that you have read and understand our terms and condition
ONLINE REGISTRATION FORM ( Fields marked with * are required )
PARTICIPATE IN :
CATEGORY :
PASTA PARTY TICKETS Adults : USD
Children : USD
FAREWELL PARTY TICKETS Adults : USD
Children : USD
Asia Runner Magazine : USD
Total Amount : USD
YELLOW CHIP CODE :
FIRST NAME :
MIDDLE NAME :
LAST NAME :
NATIONALITY :
GENDER :
BIRTH DATE : -- (DD - MM - YYYY)
AGE :  (2008 Minus Birth Year)
E-MAIL :
T-SHIRT SIZE :
ADDRESS 1 :
ADDRESS 2 :
SUBURB :
STATE / PROVINCE :
POSTAL CODE :
COUNTRY :
BUSINESS PHONE :
DIRECT LINE :
PRIVATE PHONE :
MOBILE :
FACSIMILE :
OCCUPATION :
EMERGENCY CONTACT 1 :
EMERGENCY CONTACT 2 :
OVERSEAS AIRLINE :
HOTEL IN PHUKET :
DOMESTIC AIRLINE :
Estimated Finish Time : :  (hours : minutes)
No. of Marathons completed :
Significant Athletic 
Accomplishment or 
Interesting Personal Story :
Do you have any current medical   problems or conditions for which a   doctor is treating you ? 
DETAILS :
:
Are you allergic to 
any medications ? 
DETAILS :
:
Do you wish the event medical staff
to be aware of any specific
medical problem ?
DETAILS :
:
REMARKS :
 
 
(Before you register for the race, please read our terms and conditions)
   

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