BIPAC 2023 Registration Form

BIPAC 2023

Complete the form below to register for this tournemnt
Pilot Name*

First NameLast Name
IC/Passport No.*
Gender*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Country*
state and country
National license number
NAC license / IPPI card
license rating (para pro equivalent)
License No. / Level
Sporting License no. (if any)
sporting license no. issued by NAC
CIVL no. (if any)
FAI CIVL no.
Glider and Harness Info

Glider Brand & Model

Harness Brand

Reserved BrandState / Province

Postal / Zip Code
Insurance Details

insurance company

policy no

insurance hotline no.State / Province

Postal / Zip Code
REGISTRATION FEE :
Malaysian : RM300
Foreigner : 65 euro

Entry Fee includes:
− ID Tagging
− Pilot Sticker Numbering
− T-shirt
− Transportation during competition
− Meals during competition
− Bottled Water

Payment Dateline:10th MAY 2023, 1700H
Upload your documents

Browse Files
payment slip Cancelof
T-shirt Size*
Emergency Contact*

FULL NAME

RELATIONSHIP

CONTACT NOEMAIL ADDRESS

Postal / Zip Code
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical Attention (if any)
Serious health injuries/ history/ allergy
DO NOT E-SIGN UNTIL YOU HAVE READ THE BELOW STATEMENT.
1. Completion of the online registration form confirms each Participant’s agreement to abide by the relevant Rules and Regulations of the Event which is held on the stated date, time and venue.
2. Participants are strongly encouraged to go for a medical examination and/ or consult their medical practitioner prior to registration and before the actual tournament day.The Organizer reserves the right to remove any participant deemed physically incapable of continuing with the race to prevent him/her from causing greater harm and injury to himself/herself.
3. The Organizer will not be held liable for any loss and/or damage, whether personal or otherwise, to any items during the Event.
4. Participation is at the Participant’s own risk. The Organizer is not liable for any damages in the event of accident, injury, death or any circumstances, by whatever name, suffered by a Participant as a result of the participation in the Event.
5. The Organizer reserves the right to limit and refuse entries without assigning any reasons thereof. The Organizer shall not be held responsible for any disputes arising from incomplete entry details.
6. By participating in the Event, you are agreeing to the Organizer storing and using your information as well as any images shared for any marketing purposes. We will not share your information with third parties unless you have (via other avenues) specifically agreed to us sharing these details.
Signature*

I accept the terms listed in the agreement aboveOther
Should be Empty:

BIPAC 2023

REGISTRATION FEE :Malaysian : RM300Foreigner : 65 euro

REGISTRATION FEE :
Malaysian : RM300
Foreigner : 65 euro