Team Registration Form
* Team Name
* Team Leader (Runner one)
* Runner Two
* Runner Three
* Runner Four
Address:
City:
State:    Zip Code
* Country:
* Telephone:
Fax:
* Email:
* Nationality:
Occupation:
T-Shirt Size:  S     M     L     XL
* I want to participate in:  
1/2 Mar     Mar     Ultra
Expected finish time: Hr. Min. Sec.
No. of previous Ultra Marathons:
      Longest km.      
& its time Hr. Min. sec.
No. of previous Marathons:
     
& best Marathon time Hr. Min. Sec.
Previous Dead Sea Ultra Marathon experiences:
1993      1994      1995      1996     
1997      1998      1999      2000     
2001

Fees are not refundable or transferable.
Last date for registration April 8th, 2003

Please be sure to mail or fax a photocopy of your Passport or I.D. to:
The Society for Care of Neurological Patients
P.O.Box 940222
Amman 11194
Jordan
TeleFax: 962-6 566-0296
E-mail: scnp@nets.com.jo

* Required fields

  
 
 
 
copyright 2002 © The Society for Care of Neurological Patients