EmailMe Form - World Records India - Record Registration Form

Applicants Name

First Last

Record Holders Name

First Last

(If its partnership / marathon please send seperate sheet)

Male / Female

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email Id :

Contact Number *

Date of Birth (DD/MM/YY) *

Title of World Records *

Suggested Category

Record Attempt Date *

MM / DD / YYYY

Venue of World Record *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Website or Link

Application for *

Free Listing on Website

INR 2500/- Free Website Listing + Exclusive Trophy + Certificate

Certification in Your Location.

World Record Details

Your Press Release about the record attempt OR a detailed description of your attempt, including the FULL program of the event and ALL the record(s) to be set;

Only Website Links : Online Press Release / Photos / Youtube Video if any.

Photos / News Paper Cutting / Video send through email id worldrecordsindia@gmail.com

Remarks or Any Special Instruction

Referred By :

I Accept Terms & Condition