Laguna Phuket Triathlon
Individual Triathlon Registration

Individual Triathlon
Registration
01 May 08 - 30 June 08
Thai Athletes
THB 2,000.-
Non-Thai Athletes
THB 5,500.-
Awards Banquet Ticket
1 Entry 2 Tickets maximum
01 April 08 - 31 October 08
Adult
THB 1,200.- per person
Ticket to
"Meet the Pros Social Function"
01 April 08 - 31 October 08
Adult
THB 600.- per person

Remark: Thai and Non-Thai entry fees are considered by an athlete's nationality.

ONLINE REGISTRATION FORM ( Fields marked with * are required )
*Athletes :
Awards Banquet Ticket :
* = THB
Meet the Pros Social Function Ticket : * = THB
Total Amount :  THB
Entry Date :
Yellow Chip Code :
Please fill in your yellow chip code if you have one. If not, put dash ("-") in this field. We will provide you with a chip for the race.
*Are You Racing as a Pro ?
Yes No
*Category :
Men Pro
Male 18-24 years of age
Male 25-29 years of age
Male 30-34 years of age
Male 35-39 years of age
Male 40-44 years of age
Male 45-49 years of age
Male 50-54 years of age
Male 55-59 years of age
Male 60-64 years of age
Male 65 years and Above
Women Pro
Female 18-24 years of age
Female 25-29 years of age
Female 30-34 years of age
Female 35-39 years of age
Female 40-44 years of age
Female 45-49 years of age
Female 50 years and Above
* Prefix :
* Given Name:
* Family Name:
* Nationality:
*Gender:
*Date Of Birth : - - (dd - mm - yyyy)
*Age : (Age on 7 December 2008)
*T-Shirt Size :
"Please provide full and accurate address details
as the organizers might need this for mailing your certificate"
*Address 1 :
Address 2 :
Suburb :
State / Province :
*Postal Code :
*Country of Residence :
*E-mail (First priority) :
*Confirm E-mail (First priority) :
Second 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 Accomplishment or Interesting Personal Story :
Do you have any current medical problems or conditions for which a doctor is treating you ? Yes
No
Details :
Are you allergic to any medications ? Yes
No
Details
Do you wish the event medical staff to be aware of any specific medical problem ? Yes
No
Details :
Remarks :
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.
 
 
(Before you register for the race, please read Race Rules)
   
 

(*Registration for events, online registration forms can function properly only on Internet Explorer and Safari*)

© 2008 GO ADVENTURE ASIA : 109 FL.5, CCT BUILDING, SURAWONG ROAD, BANGRAK, BANGKOK 10500 THAILAND  Tel. +66 2 236 2931 up to 2  Fax. +66 2 237 2321