"Super Run" Everyone can be a hero! Registration Form

"Super Run" Everyone can be a hero! Registration Form
Race Map
Location: Lake Garden Kuala Lumpur

Race Dates: 23rd July 2022

Time: 7:00AM - 9:00AM

Race Distance: 3 KM
Participant Details
Father's Full Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Age
Phone Number
Format: (000) 000-0000.
T-shirt Size
Mother's Full Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Age
Phone Number
Format: (000) 000-0000.
T-shirt Size
Child's Full Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Age
T-shirt Size
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal
Emergency Contact Person

First NameLast Name
Emergency Person Phone Number
Format: (000) 000-0000.
Registration Payments
Payment Method
Registration Fee
prevnext( X )
Group A - 2 Parents 1 Child
120.00 MYR

Group B - 1 Parent 1 Child
80.00 MYR

Total

0.00 MYR
Waiver & Release
Should be Empty: