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Title Sponsor

Associate Sponsor

By using this form, you will be able to apply only for the Marathon (42.195 km) and Half Marathon (21.097 km) race categories. Registrations for Dream Run, Sr. Citizens' Run and Wheelchair Event will open on Wednesday, 1sh September 2010. Your entry to the marathon/half marathon category will be confirmed based on confirmation preference criteria, which are explained in detail in this form. Please go through all details mentioned in this overleaf and the Application Form prior to submitting your application. We urge runners to apply for the race category only if you can complete the marathon (42.195 km) distance within 6 hours or the half marathon (21.097 km) distance within 3 hours, as the case may be. Looking forward to your continued patronage.
An applicant needs to be of 18 years or more on the date of race, i.e. born on or before 15th January 1993.

You can apply for the Event using any one of the following modes. Applications will be accepted up to Saturday, 21st August 2010 or as soon as running places are filled, whichever is earlier: • Online – through the event website • Post – Post your filled application form and requisite application (1) 87, Bhulabai Desai Rd, Breach Candy; (2) 90 M.G Road, Fort; fee to P Box No. 11017, Marine Lines Post Office, Mumbai - 400 020. (3) Shivaji Mandir, NC Kelkar Rd., Dadar; (4) Unique Centre, Waterfield Rd., .O. • Deposit in Bank – Deposit in Bank – Local Mumbai residents can Bandra (West); (5) 170-A Derasar Lane, Ghatkopar (East), TPS II; (6) Ameya House, Rajkumar Corner, J. P. Road, Andheri (West); (7) Garden Apartment, deposit their application forms along with requisite application Diamond Garden CHS Ltd., A Sores Rd, Chembur; (8) Aditya Apartments, fees at the following Standard Chartered Bank branches in Chandravarkar Rd., Borivali (West); (9) Emerald Plaza, Block No.2, Pokahran Mumbai. Bank timings: 10 am to 6 pm from Monday to Friday, and Rd. No. 2, Thane 400601; (10) Junction of Juhu & S V road, Santacruz. between 10 am and 4 pm on Saturday – Forms can also be downloaded from the event website In Mumbai, forms are available at the Standard Chartered Bank branches, the Asian Heart Institute at Bandra Kurla Complex, Bandra (East), Mumbai and the United Way of Mumbai office at 309, Kewal Industrial Estate, Senapati Bapat Marg, Lower Parel (W), Mumbai.

Marathon and Half Marathon races are compulsorily timed categories. Application type/Fee constituent Domestic Applicants (applicants residing in India) *Overseas Applicants (applicants residing outside India) Marathon 600 USD 40 Half Marathon 600 USD 40

* Overseas applicants are required to apply only online through the event website -

• Cheque (Only local Mumbai cheques will be accepted) • Cash (Only Indian Rupee currency will be accepted) • Demand Draft/Pay Order (payable at Mumbai) • Credit Card, Net Banking and Debit cards (Can be used only for online registration) Note: (i) All cheques and demand drafts to be drawn in favour of “PROCAM INTERNATIONAL LTD. – SCMM”, (ii) Please write your full name, the race category chosen and contact number on reverse of cheque/demand draft.

Your application for the marathon/half marathon is confirmed based on the preference criteria given below. Please note, confirmation is subject to – ü Verification of documents, where applicable, submitted by you, ü Verification of your application's eligibility under each criterion, ü Availability of running spaces under each criterion and ü Entry Rules and Guidelines.

Confirmation Criteria
1) Timed applicant: For an applicant who has participated in an event and completed the distance of marathon within 6 hours and/or a half marathon within 3 hours. In order to be eligible for this criteria –
a. The running event you have participated in, must have been an AIMS ratified event or an event conducted under the aegis of your national/state/district athletics association or sports control board, b. The running event was conducted within 2 years prior to your application date, c. You have attached a signed photocopy of the official timing certificate issued to you at this event along with this application form.

2) Women's Quota: There are a limited number of running places reserved for Women applicants.

Ballot Process Rules and Entry Rules & Guidelines given herein. No running number. at 309. 3) Applicants must submit their entries only via the Application Modes given in this form. please check the following – a) Filled in details against all mandatory fields prefixed with '*' in the application form. You can also check the status of your entry post 27th August 2010 on the event Health Equipment Partner Sports Drink Partner Logistics Partner . EVENT CONTACT DETAILS Event Helpline: +91 22 42020200 (Mon to Sat. to send in your application. Mumbai 400013 (Mon to Fri. 13) Confirmed participant’s identity and proof of residence might be verified by a verification agency hired for validating the details provided by you in the 16) This entry form and the right to participate in the event and the rights and benefits available to the applicant under this entry form is at the sole discretion of the event Promoters. An amount of Rs. Confirmation of applications received will be subject to the applicable confirmation preference Use your run to give back to a cause. do not send in more than one entry per person. 15) Unsuccessful applicants can approach participating NGO's for available Charity running 8) Post close of registrations. Lower Par el (W). multiple applications will entail all being rejected.procamrunning. 6) Where any discrepancy is found in any of the above mentioned mandatories. for whatsoever reasons other than the application being rejected/invalid. or where an application cannot be confirmed under either of the 2 above criteria.. the entry fees paid by you will be refunded on or before 31st October 2010. 10 am to 7 pm) Website: www. against fee of Rs 50/-. Kewal Industrial Estate. No individual/group has been authorised to collect entries on behalf of the Event. If you do not receive any intimation from the race office. 30 will be deducted as processing charges. Also. For information on the list of participating NGO's having such charity running numbers and for rules guiding availability of such numbers. 12) All confirmed participants / their authorised representatives are required to come to the Standard Chartered Mumbai Marathon Expo scheduled from 12th January 2011 to 15th January 2011 in or der to collect their running number bibs and timing chips and goodie bag. You can write to scmm@procam. his/her application will be placed under the ballot process. 14) Please thoroughly go through all information mentioned in this form prior to submitting your application. Veteran. marathon and half marathon runners will be further confirmed into 4 sub-categories based on the date of birth mentioned in the application form – Open. 27th August 2010. Senior Veteran and Super Veteran sub-categories. For more information on fundraising. Where your entry is not confirmed for any reason. 7) On entry confirmation. log on to the event website www. 4) NO GROUP ENTRIES will be accepted for the Marathon and Half Marathon race categories. refund will not be entertained. 10 am to 7 pm).in 9) Entries not accepted: Participation in the event is subject to entry confirmation. An amount of Rs.000 Marathon applications will be placed under the ballot pool. 30 will be deducted as processing charges. e) Signed the 'waiver' in the form. Please go through Ballot Process Rules given below prior to submitting your application.procamrunning. 2) Only one applicant can apply for the Event using a single form. the proceeds going for the benefit of the chosen NGO. and cannot be transferred to any other person under any Alternatively. For more information log on to www. List of participating NGOs registered with United Way of Mumbai can be viewed on the event website. 2500 Half Marathon and 1000 Marathon applications out of the total entries received in the ballot pool will be randomly selected via an automated system and confirmed. Such charity running spaces will be available at a premium.procamrunning. ENTRY RULES AND GUIDELINES 1) You may use a photocopy of the physical or downloaded form from the event website. b) Attached documents as may be required to confirm your entry based on the confirmation preference criteria.procamrunning. Procam International Ltd. Acceptance letters and event information will be posted on the address given in the entry on Friday. log on to event website www. free of cost. RUN FOR A CAUSE Participants who wish to raise pledges for a charity of their choice can download the Pledge Raising Kit. 5) Before sending in your application. please contact our event helpline number or email us at scmm@procam. 10) Any refund discrepancies must be brought to the attention of the Event Registration Team E-mail: scmm@procam.000 Half Marathon applications and 2. List of confirmed runners through the ballot process will be declared on the event website (www. The applicant alone shall be entitled to the rights and benefits arising out of such confirmation of Refund queries will not be entertained post 30th November 2010. United Way Mumbai. Senapati Bapat Marg. c) Attached a copy of your latest passport sized photograph on the form. d) Enclosed the requisite application fees (refer to 'Application Fees' chart). your application will not to be accepted.procamrunning. Please note application fees paid against unsuccessful applications placed under the ballot pool will be refunded on or before 31st October 2010. 11) Requests for cancellation and thereby. BALLOT PROCESS RULES A total number of 5. from the event website: www. email confirmations will be sent to all the confirmed participants who have given their valid email id in the entry form.3) Ballot pool: Where an applicant does not fall under either of the above criteria. applicants residing in Mumbai can also avail of a Pledge Raising Kit from the Event's Charity Partner.procamrunning. timing chip or goodie bag will be posted to individual mailing addr esses.

) . 'Ballot Process Rules' and 'Entry Rules & Guidelines' in the form overleaf: (1) Timed Runner (attach recent timing certificate) (2) Women's Quota (3) Where you do not fall in either of the above 2 criteria. ): (tick Service. if applicable? • Filled all mandatory fields (marked ‘ ’)? • Included the correct applicable fee? • Signed the Waiver? Marathon Marathon Marathon * Race Category (tick any one) ü Marathon .001 to 15./ Mobile No. Number: (STD Code) (Telephone No.000 any one) ü 5.001 to 200.00 200. please go through information under 'Confirmation Preference Criteria'.000 15.001 to 100. For details. Housewife.01.2011 * Tel.) * City/Town: * State: * Nationality: (dd/mm/yy) Age as on 15./ Mobile No. Student Monthly Household Income ( < 5. Self-Employed. Number: Occupation: (tick ü any one) Business.00 & above * Contact name & number of family/friend/guardian in case of emergencies Name: * Tel. • Fully read the Information in the overleaf of this Application Form? • Chosen your race category (any one)? • Affixed your recent passport sized photograph? • Attached a photocopy of your latest timing certificate.001 to 50. your application will be put within the ballot pool.000 50.42.Title Sponsor Associate Sponsor Marathon & Half Marathon APPLICATION FORM Marathon & Half Marathon APPLICATION FORM Please fill up the form in CAPITAL letters only APPLICATION FORM Marathon & Half Marathon Half Marathon Half Marathon Half Marathon Half Marathon .Address: (STD Code) (Telephone No. Retired.097 km Affix your recent Photograph Size (1.21. PERSONAL INFORMATION * First Name: *Address: * Last Name: * Area: * Landmark: * Pin Code: * Gender: Male Female * Country: * Date of Birth Email .000 100.195 km Confirmation Preference: Entries will be confirmed for respective race categories as per the order of preference given below.2 inch) CHECK LIST: HAVE YOU….2 inch x 1.

officials and volunteers. I shall pay or reimburse to you my/my ward's medical and emergency expenses and l/my ward hereby authorize/s you to incur the same. riots or other civil disturbances.* I/my ward do agree to receive information. any claims that might result from me/my ward participating in the event and whether on account of illness. offers. officials or volunteers or Procam International Limited or any persons or entities associated with the event or the directors. for the sole purpose of promoting the Standard Chartered Mumbai Marathon. (I) the information given by me/my ward in this entry form is true and me/my ward is/am solely responsible for the accuracy of this information. (vii) shall provide to race officials such medical data relating to me/my ward as they may request. or any of the Standard Chartered Mumbai Marathon Committee persons. with all/any entities associated with the Standard Chartered Mumbai Marathon. waive all claims of whatsoever nature against any and all Sponsors of the event. Applicant's Signature www. . even if the course may be regulated/ policed. authorities and officials. agree and irrevocably permit Procam International to use my/my ward's photograph which may be photographed on Race Day and/or during the Standard Chartered Mumbai Marathon Expo. all Standard Chartered Mumbai Marathon Committee persons. an appropriate level of fitness to participate in such a physically demanding event and l/my ward have obtained a medical clearance from a registered medical practitioner. (ix) understand. employees. (iii) understand the risk of participating on a course with vehicular traffic. death or otherwise. (xi) shall not hold the organizers and all/any of the event sponsors responsible for loss of my/his/her entry form and/or entry fee in transit.procamrunning.: Demand Draft Cash Amount in Rs. Chq/DD Date: (dd/mm/yy) Cheque / DD in favour of “PROCAM INTERNATIONAL LTD. earthquakes. (vi) agree that if I am/my ward is injured or taken ill or otherwise suffer/s any detriment whatsoever. but not limited to. I hereby irrevocably authorize the event officials and organizers to. agree and irrevocably permit Procam International to share the information given by me/my ward in this application. Bank Name & Branch: *Refund Refund cheques (after deducting processing charge of Rs 30 per application) to be drawn in favour of Charity (tick ü any one) Do you wish to support any of the following causes given below – you can choose more than one cause: Education Disability Women Empowerment Rural development Elderly Others If options have been selected. all contractors and construction firms working on or near the course. injury. transport me/my ward to a medical facility and/or to administer emergency medical treatment and l/my ward waive/s all claims that might result from such transport and/or treatment or delay or deficiency therein. storms. typhoons or any terrorist act. at its own discretion. none of the sponsors of the event or any political entity or authorities and officials or any contractor or construction firms working on or near the course. agents or representatives of all or any of the aforementioned shall be held liable by me/my ward or my/my ward's representatives. (iv) understand that l/my ward must be of. (viii) in case of any illness or injury caused to me or my ward or death suffered by me or my ward due to any force majeure event including but not limited to fire. allowing me to participate in the event/s. (xii) I/my ward understand and agree to the event terms and guidelines. (v) for myself/ourselves and our legal representatives. I agree that nothing herein shall oblige the event officials or organizers or any other person to incur any expense or to provide any transport or treatment. (x) understand. agents and representatives of all or any of the aforementioned including. at my/our risk and cost. (ii) have fully understood the risk and responsibility of participating in the Standard Chartered Mumbai Marathon or any event outlined in this application (collectively "the event") and will be participating entirely at my/his/her risk and . *Waiver (Must be signed for entry acceptance) I declare. pamphlets. employees. and must train to. Procam International Limited and all other persons and entities associated with the event and the directors. Mumbai City. sampling and advertising of various brands/products/services as may be sent to me/my ward by the event promoters (or any other person duly authorized by the promoters) on the contact details given by me/my ward in this entry form: Yes No any one) *Payment Mode (tick ü Cheque Chq/DD No. all political entities. you will be contacted on your email id and will be guided on how to support the cause selected by you.SCMM”. confirm and agree as follows and I/my ward …. at its own discretion.