Registration Form for the Pi World Ranking List

 
Last Name                      First Name                      Date of Birth (optional)
 
 
Street                              Zip Code                        City
 
 
Country                           Continent                        Email (optional)
 
 
Day               Month             Year                Time :       Start         Finish
 
I declare the following performance :
 
I recited the number Pi totally from memory and without any outside help and without any errors with an accuracy of
 
        digits.

I am already a member of the Pi World Ranking List    Yes  /  No
 
I declare that I read the rules and understand them.
I will take no legal action in any case.
 
 
Place             Date              Signature
 
The following persons witnessed my performance and testify  that it fulfils the rules:
 
1st witness                                           2nd witness
 
   
Last Name, First Name                       Last Name, First Name
 
   
Address                                              Address
 
   
Place, Date, Signature                         Place, Date, Signature
 
 In case the performance is 10,000 digits or more :
 
 
 
 
Certification, Title and Stamp of the official witness