OFFICIAL ENTRY FORM

Mt. Meru International Marathon Arusha, Tanzania

No.

Official use

Please use block letters

Surname _____________

First Name _____________

Nationality

Sex (M or F) Date of Birth

day/month/year Official use

Address ___________________________

Occupation ___________________________

Number of Marathons completed

Marathon Personal Best time H:M:S ___:___:___ Place __________

Where and When? ___________________________

I enclose my entry fee of US. $20

Please make cheques or money orders. Payable to:

Mt. Meru International Marathon Arusha, Tanzania.

Let’s have some other information that may be of interest to the local and International media.

Thank you.

I declare that I am eligible to compete as defied by IAAF rules. I hereby agree that the organizers shall not be liable for any accidents, injury, fatality, loss or damage as a consequence of my participation in the Mt. Meru International Marathon.

I give permission for the free use of my name, voice or picture in any broadcast, telecast, advertising promotion or other account of this event.

Signature __________________ Date ____

Send To:

Mount Meru International Marathon P.O.Box 855 Arusha, Tanzania.

Telephone +255-27-2502394 Fax +255-27-2502271 Mobile: +255 744 219090

e-mail rasarusha@yahoo.com