Fearless MTB Jamboree 2013

Fearless MTB Jamboree 2013

Registration Form
Nama / Name
No. KP / IC No.
Passport No.
For non-Malaysian citizen only
Alamat / Address

Bandar / CityNegeri / State

Poskod /PostcodeCountry
E-mel / E-mail
No. Telefon / Phone No.
Kelab/Persatuan
Club/Organisation
Saiz T-Shirt / T-Shirt Size
Saya bersetuju untuk menyertai acara 'Fearless MTB Jamboree' di atas tanggungan sendiri dan tidak akan mendakwa pihak penganjur sekiranya berlaku sebarang kecederaan dan kemalangan sewaktu menyertai kayuhan ini.

I hereby agree to indemnify, defend and hold harmless 'Fearless MTB Jamboree' and the organisers from and against any and all losses, liabilities, damages, injuries, medical fees and any other costs and expenses which I may incur as a result of my participation in the activity.

_________________________________________________________________________________________

Yuran penyertaan adalah RM 50 dan boleh didepositkan mengikut maklumat di bawah. Tarikh akhir untuk mendaftar ialah pada hari Ahad, 10 Februari 2013. Sekiranya anda mempunyai sebarang pertanyaan, sila hubungi kami melalu e-mel, timoreniaga@gmail.com.

The registration fee is RM 50 and can be deposited following the details below. Application deadline is Sunday, 10th February 2013. If you have any inquiries, please email us at timoreniaga@gmail.com.

TIMORE NIAGA SDN. BHD.

RHB Bank: 2123 1200 0556 46
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