For Dream Run (6 km) Race Category onlyMin. Age eligibility: 12 yrs (born on or before 18/1/2002)

Registration Start Date: 10 am IST on Monday, 26th August 2013 End Date: Saturday, 31st August 2013 or .as soon as running places are filled, whichever is earlier

APPLICATION FEES

Domestic Applicants (applicants residing in India) ` 700

*Overseas Applicants (applicants residing outside India) USD 30

Applicant type Fee (inclusive of service tax#)

19.01.14

Dear Applicant,

This application form covers application for the Dream Run (6 km) race category only. Registration for Sr. Citizens' Run and Champions with Disability will open on Monday, 2nd September 2013 at 10 am IST.

Please go through the information given hereunder thoroughly prior to submitting your entry.

Looking forward to your continued patronage.

Important Information

Group entries: More than 35 entries from any single group/entity or association, either from the online or offline mode will NOT be accepted.

Group entries: A covering letter on a company/NGO/ any entity's official letterhead is compulsory. Refer to Entry rules & Guidelines for more details.

A duly filled application form needs to be submitted with a copy of Govt. issued photo ID proof i.e. either passport, PAN card, or Aadhaar card.

Applicants below 18 yrs can submit their identity card issued by their school / college.

Individual entries: One representative can submit up to 10 individual application forms

*Overseas applicants are required to apply only online via www.procamrunning.in/scmm (event website)

# Service Tax No. AABCP7300EST001

PAYMENT MODES

Cheque (Only local Mumbai cheques will be accepted)Demand Draft/Pay Order (payable at Mumbai)Cash (Only Indian Rupee currency will be accepted)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.

HOW TO APPLY?

Form availability: Application forms are available at select Mumbai Standard Chartered Bank branches, at the Asian Heart Institute at Bandra Kurla Complex, Bandra (East), Mumbai and at the United Way of Mumbai office at 309, Nirman Kendra Premises Co-op society ltd., Dr. E. Moses Road, Mahalaxmi Estate, Mumbai. Application forms are also available for download online @ www.procamrunning.in/scmm.

You can use ANY ONE of the following modes for applying for this Event.Online: Log on to the event website www.procamrunning.in/scmm. Deposit in Bank: Local Mumbai residents can deposit their application forms along with requisite application fees at the following Standard Chartered Bank branches in Mumbai. Bank timings: 10 am to 6 pm from Monday to Friday, and between 10 am and 4 pm on Saturday– (1) 87,

Bhulabai Desai Rd, Breach Candy; (2) 90 M.G Road, Fort; (3) Shivaji Mandir, NC Kelkar Rd., Dadar; (4) Unique Centre, Waterfield Rd., Bandra (W); (5) Ameya House, Rajkumar Corner, J. P. Road, Andheri (W); (6) Garden Apartment, Diamond Garden CHS Ltd., A Sores Rd, Chembur; (7) Aditya Apartments, Chandravarkar Rd., Borivali (W); (8) Emerald Plaza, Block No.2, Pokahran Rd. No. 2, Thane; (9) Center Point, Junction of Juhu & S V Rd, Santacruz (W) (10) 170-A Derasar Lane, Ghatkopar (East), TPS II.

Post: Post your filled application form and application fee to P.O. Box No. 11017, Marine Lines Post Office, Mumbai - 400 020.

ARE YOU FIT TO PARTICIPATE?

Please review the following questions before submitting your application form. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?Do you feel pain in your chest when you do physical activity?In the past month, have you had chest pain when you were not doing physical activity?Do you lose your balance because of dizziness or do you ever lose consciousness?Do you have a bone or joint problem that could be made worse by a change in your physical activity?Is your doctor currently prescribing drugs for your blood pressure or heart condition?Are you pregnant?Do you have insulin dependent diabetes?Do you know of any other reason why you should not do physical activity?

If you have answered YES to any of the questions above, then please consult your physician before applying for registration in Standard Chartered Mumbai Marathon. Irrespective of whatever may be your age, we sincerely advise you to obtain a medical clearance from a registered medical practitioner/doctor before applying for the Standard Chartered Mumbai Marathon 2014. It is unfair to you and your family to risk serious illness and become a medical emergency on race day.

ENTRY RULES AND GUIDELINES

1. You may use a photocopy of the physical or downloaded form from the event website, to send in your entry.2. Only one applicant can apply for the Event using a single form. Also, do not send in more than one entry per person; multiple applications will entail all being rejected.3. Applicants must submit their entries only via the Application Modes given in this form. No individual/group has been authorised to collect entries on behalf of the Event.4. Before sending in your application, please check if you..

have filled in details against all mandatory fields prefixed with ' ' in the application form;*have affixed a copy of your latest colour passport sized photograph on the form;

have attached a copy of either your Aadhar card, PAN card or passport to the form;

have enclosed the requisite application fees (refer to 'application fees' chart);

have signed the 'waiver' in the application form;

have met the minimum age eligibility criteria for the chosen race category.

5. Where any discrepancy is found in the above mentioned mandatories, your application will be rejected.6. Individual entries: One representative can submit up to 10 individual application forms in Dream Run race category.7. Group entries:

i. Total number of entries enclosed in each race category, ii. Number, date, amount and bank name of cheque/DD submitted, iii. Name and contact details of one common point of contact for the group; iv. Covering letter needs to be on a company/NGO/ any other entity's official letter head, duly signed and stamped by the authorized signatory of the entity.

If applicant is below the age of 18 years, the guardian has also signed the 'waiver' and written his/her relation with the applicant.

a. Where 20 or more individuals submit their entries together, this will constitute a group entry. All members of a group have to fill and sign individual entry forms. Under 'Application Type' in the entry form, applicants need to choose 'Group', mentioning the group name and size of the group.b. More than 35 entries from any single group/entity or association applied either through online or offline mode will NOT be accepted.c. Please DO NOT club Marathon and Half Marathon entries with group entries. Such entries will be disqualified.d. Only one cheque/DD will be accepted for group entries.e. Each group must submit their entries together one time, in a single envelope under a covering letter on a official letterhead issued by the company/NGO/ any entity stating –

8. Post close of registrations, email confirmations will be sent to all the confirmed participants who have given their valid email id in the application form. In case of group entries, as per the rules and guidelines stated in point no 7 above, the point of contact of the group will be receiving email confirmation for confirmed participants of the group.

9. Acceptance Letters: Physical acceptance letters and event information will be posted ONLY to those applicants who have not given their email address in the application form. You can also check the status of your entry post 7th September 2013 on the event website. If you do not receive any intimation from the race office, please contact our event helpline number +91 22 42020200 or email us at scmm@procam.in

12. Running number bib collection:12.1 All confirmed participants/their authorised representatives are required to come to the Get Active Expo in Mumbai scheduled from 10th January 2014 to 12th January 2014 in order to collect their running number bibs. No running number BIB will be posted to individual mailing addresses.

12.2 In case of unavoidable circumstances, such runner can send his/her representative to collect running number bib on his/her behalf.

. Please note, in case of individual entries, a representative will not be allowed to collect

running number bib on behalf of more than FIVE Dream Run participants12.3 Authorised representative must carry with him/her (a) the original acceptance letter, or a print of either the email confirmation sent by us or the confirmation status on the event website, (b) photocopy of photo-identity proof (Aadhar card, PAN card or passport) of the representative and the confirmed participant.

12.4 Outstation and overseas participants can collect their running number on Saturday, 18th January 2014.

13. Confirmed runner's identity and proof of residence may be verified by a verification agency hired for validating the details provided by you in the form. Where the identity and/or proof of residence of a runner is found incorrect or incomplete, participation of the said runner will be withheld and there will be no refund of application fees paid by the said runner. 14. Please thoroughly go through all information mentioned in this form prior to submitting your application. Confirmation of applications received will be subject to the Entry Rules & Guidelines given herein.

15. Unsuccessful applicants can approach participating NGO's for available Charity running numbers. Such charity running spaces will be available at a premium, the proceeds going for the benefit of the chosen NGO. For information on the list of participating NGO's having such charity running numbers and for rules guiding availability of such numbers, log on to www.unitedwaymumbai.org/scmm.

RUN FOR A CAUSEParticipants who wish to raise pledges for a charity of their choice can create a fundraising page by logging on to www.unitedwaymumbai.org/marathon

List of participating NGOs registered with Standard Chartered Mumbai Marathon through United Way of Mumbai can be viewed on the event website.

For more information on fundraising, log on to the event website www.unitedwaymumbai.org/marathon. It's good to Run, but it's better to Run for a Cause!

CONTACT US

Event Helpline: +91 22 42020200 (Monday to Saturday, 10 am to 7 pm)

Website: www.procamrunning.in/scmm.E-mail: scmm@procam.in

Registrations for Sr. Citizens' Run and Champions with Disability

will start on 2nd September 2013.

10. Entries not accepted: Participation in the event is subject to entry confirmation. Where your entry is not confirmed for any reason, the entry fees paid by you will be refunded on or before 31st October 2013. An amount of ` 50 will be deducted as processing charges. Any refund discrepancies must be brought to the attention of the Event Registration Team immediately. Refund queries will not be entertained post 30th November 2013.11. Requests for cancellation and thereby, refund will not be entertained.

16. This application 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, Procam International Ltd., and cannot be transferred to any other person under any circumstances. The applicant alone shall be entitled to the rights and benefits arising out of such confirmation of participation.

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STANDARD CHARTERED MUMBAI MARATHON 2013STANDARD CHARTERED MUMBAI MARATHON 2013

APPLICATION FORM APPLICATION FORM

STANDARD CHARTERED MUMBAI MARATHON 2013

STANDARD CHARTERED MUMBAI MARATHON 2013

STANDARD CHARTERED MUMBAI MARATHON 2013

STANDARD CHARTERED MUMBAI MARATHON 2013

STANDARD CHARTERED MUMBAI MARATHON 2013

STANDARD CHARTERED MUMBAI MARATHON 2013

* Affix your recent color photograph

with your face clearly visible

Size: (1.2 inch x 1.2 inch)

Please fill up the form in CAPITAL letters only

CHECK LIST: HAVE YOU….

APPLICATION FORMFor Dream Run race category

• Fully read the information in the overleaf of this Application Form?

• Affixed your recent passport sized photograph?

• Included the correct application fee?

• Attached a copy of your Govt. issued photo ID proof

• Filled all mandatory fields (marked ‘ ’)?

• Signed the Waiver?

PERSONAL INFORMATION

* Gender: Male Female

* Tel. Number: (STD Code) (Telephone No./ Mobile No.)

Email - Address: 1)

2)

(All applicants will receive confirmation of their application and event related information on the email id mentioned above, physical confirmation letter will only be sent to applicants without email id)

* First Name: * Last Name:

* City/Town:

* Pin Code: * State:

* Nationality: * Country:

*Address:

* Date of Birth: (dd/mm/yy) Age as on 18.01.2014:

Occupation: (tick any one)üBusiness,

UnemployedSportsperson,

Self-Employed, Salaried Retired, Housewife, Student, Govt. Employee,

* Contact name & number of family/friend/guardian in case of emergencies (should be a person not participating in the event)

* Name:

* Tel. Number: (STD Code) (Telephone No./ Mobile No.)

* APPLICATION TYPE (tick any one)ü

Individual Entry / Group Entry

Group Name :

Group Size : (Group size not to be more than 35 people)

Chq/DD Date: (dd/mm/yy)Cheque / DD in favour of

“PROCAM INTERNATIONAL LTD. – SCMM”.

Bank Name & Branch:

Chq/DD No.:

Amount in `ü(tick any one) Cheque Demand Draft Cash

*PAYMENT INFORMATION

*REFUND

In case of entry not accepted, the refund via NEFT will be made in favour of __________________________________________________

( 50 will be deducted as processing charges and you will be contacted on your email asking for your NEFT / Bank account details) `

*Waiver (Must be signed for entry acceptance)

I, __________________________________(full name), declare, confirm and agree as follows and I/my ward ….

(i) have given true and complete information in this application form and me/my ward is/am solely responsible for the accuracy of this information; (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 responsibility; (iii) understand the risk of participating on a course with vehicular traffic, even if the course may be regulated/ policed; (iv) understand that l/my ward must be of, and must train to, 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, allowing me/ my ward to participate in the event/s; (v) for myself/ourselves and our legal representatives, waive all claims of whatsoever nature against any and all Sponsors of the event, Mumbai City, all political entities, authorities and officials, all contractors and construction firms working on or near the course, all Standard Chartered Mumbai Marathon Committee persons, officials and volunteers, Procam International Limited and all other persons and entities associated with the event and the directors, employees, agents and representatives of all or any of the aforementioned including, but not limited to, any claims that might result from me/my ward participating in the event and whether on account of illness, injury, death or otherwise; (vi) agree that if I am/my ward is injured or taken ill or otherwise suffer/s any detriment whatsoever, I/we hereby irrevocably authorize the event officials and organizers to, at my/our risk and cost, 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. 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; (vii) shall provide to race officials such medical data relating to me/my ward as they may request. 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; (viii) in case of any illness or injury caused to me or my ward or death suffered by me or my ward during the race, or at any time thereafter as a result of the event, due to any medical reasons or medical condition (regardless or not whether such medical reasons or condition shall have been pre-existing conditions known by me and further regardless of whether I/my ward shall have disclosed the existence of such reason or condition to any person) or due to any force majeure event including but not limited to fire, riots or other civil disturbances, earthquakes, storms, typhoons or any terrorist act, 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, or any of the Standard Chartered Mumbai Marathon Committee persons, officials or volunteers or Procam International Limited or any persons or entities associated with the event or the directors, employees, agents or representatives of all or any of the aforementioned shall be held liable by me/my ward or my/my ward's representatives (ix) understand, agree and irrevocably permit Procam International to share the information given by me/my ward in this application, with all/any entities associated with the Standard Chartered Mumbai Marathon, at its own discretion; (x) understand, agree and irrevocably permit Procam International to use my/my ward's photograph which may be photographed on Race Day and/or during the Get Active Expo, for the purpose of promoting the Standard Chartered Mumbai Marathon, at its own discretion; (xi) shall not hold the organizers and all/any of the event sponsors responsible for loss of my/his/her application form and/or application fee in transit; (xii) I/my ward do agree to receive information and offers of various brands/products/services as may be sent to me/my ward by the event promoters (or a person duly authorized by the promoters) on the email address given by me/my ward in this application form; (xiii) I/my ward understand and agree to the event terms and guidelines.

Applicant's Signature

CHARITY ü(tick )

Standard Chartered Mumbai Marathon is a unique platform to raise funds and support your chosen cause. Do you wish to support any of the causes registered with United Way of Mumbai?

You will be contacted on your email id and will be guided on how to support charity.

Yes No (If Yes, please visit www.procamrunning.in/scmm)

Guardian's Signature

If applicant is under 18 years of age as on 18.01.2014

Name & relation of Guardian with Applicant