1. PLEASE PAY REGISTRATION FEE
JOIN PTACH
in the 2012
JERUSALEM MARATHON
 
Friday , March 16, 2012
כ"ב אדר  תשע"ב
 
WALK or RUN
– 10 , 21 or 42 Kilometers
under the beautiful Jerusalem Skies
Get in Shape and Raise Scholarship Money for our Ptach Children
 
For more information call
Rivke Grunberg - 02 651-1356
 
Registration Fee
180 Shekel (includes t shirt)
I am committing to raise a minimum of 3600 shekel( $1000) in sponsorships for our PTACH children.

I hereby declare that I am in good health and physically capable of running/walking the marathon. I will not hold the Municipality of Jerusalem or PTACH responsible for any injuries or damage that might incur as a result of the marathon.
  
Payment may be made either by check made out to PTACH or by clicking on this link.

Forms may also be mailed to PTACH at:
PO Box 34465 / Jerusalem, Israel 91344
2. FILL OUT THE ONLINE FORM BELOW
PTACH Jerusalem Marathon 2012
Name *

First
Last
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Email *
Confirm *
Phone *
Please enter your area code and phone number, ie (02) 123-4567
Cell Phone *
Please enter your area code and phone number, ie (052) 123-4567
ID # (Teudat Zehut or Passport) *
Year of Birth *
T-Shirt Size *
 X Small 
 Small 
 Medium 
 Large 
 X Large 
 XX Large 
Terms of Agreement *
 I Agree (Check Here) 
I am committing to raise a minimum of 3600 shekel ($1000) in sponsorships for our PTACH children.
I hereby declare that I am in good health and physically capable of running/walking the marathon. I will not hold the Municipality of Jerusalem or PTACH responsible for any injuries or damage that might incur as a result of the marathon.
Powered byEMF Web Forms Builder
Report Abuse