Real Berlin Application

Thank you for applying to run in the Real, - BERLIN MARATHON with Susan G. Komen for the Cure® Team Marathon on September 27, 2009. Please fill out the below information and submit it to us via this online form. Runners will be selected based off of fundraising goal and reason for wanting to run with Team Marathon.

Applications must be received no later than Friday April 3, 2009

Runners will be chosen and notified via phone call and email no later than Friday April 10, 2009

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First Name

Middle Initial

Last Name

Street Address

City

State

ZIP Code

Country

Date of Birth (MM/DD/YYYY)

Age

(You must be at least 18 on the date the event commences in order to participate.)

Home Phone

Enter a valid phone number. Example: 123-456-7890

Business Phone

Enter a valid phone number. Example: 123-456-7890

Cell Phone

Enter a valid phone number. Example: 123-456-7890

Gender

Email Address

Enter a valid email address. Example: name@company.com

Fundraising Goal ($)

Runner will be asked to commit to a minimum of $2,200

Number of marathons previously run

How did you hear about Susan G. Komen for the Cure Team Marathon?

Why do you want to run for Team Marathon?