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Pan Pacific Bangkok
Walk 4 Women 2009
Individual Registration

Race Type	Now - 30 January 09
Individual	THB 1,000.-
Casual Participation *	THB 500.-

* Casual Participation is designed for people who would like to show their support of the good cause of the Pan Pacific Walk 4 Women but are not serious about recording their distance or walking for a prolonged period of time. Casual participants will receive a participant t-shirt and access to the participant food. Casual participants will not receive a distance recording chip, participant medal, or bib number. Casual participants must wear the participant t-shirt during their walk and when accessing the participant food area.

Note:

Please make sure that you provide all relevant information
We only accept online payment through VISAor MasterCard
The fee for the race is non-refundable!
Registration on the race day is Not Accepted

The Entry Fee includes:

Race registration, running number *Except for casual participants who will not get a running number
Pre-race souvenir pack (number, t-shirt, etc.)
Food during and after the race
Commemorative medal for everyone, *Except for casual participants
Certificate showing the total distance walked/run. The certificates will be post mailed (to individuals and team's captains) after the event, *Except for casual participants
Trophies for category winners

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 dash (-) in this field. We will provide you with a chip for the race.
* Participate in :	Individual (THB 1,000 + ChampionChip Deposit THB 200) Casual Participation (THB 500)
*Category :	Invidual Male 18-29 years of age Male 30-39 years of age Male 40-49 years of age Male 50 years and Above Female 18-29 years of age Female 30-39 years of age Female 40 years and Above	Casual Participation
*Given Name :
*Family Name :
*Nationality :
*Gender :
*Date Of Birth :	- - (dd - mm - yyyy)
*Age :	(Age on 7 February 2009)
*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 :
*Mobile :
Facsimile :
*Emergency Contact Person 1 :
*Emergency Contact Telephone 1 :
Emergency Contact Person 2 :
Emergency Contact Telephone 2 :
Remarks :
I certify that I am medically fit to compete 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*)