MYBUDDIES RUN 2017

Registration Form

Events

*Select an event to participate

Group Representatives

*Team Name

*Representative's Name

*Representative's Email

*Phone Number Eg: 0312345678

Participant 1

*First Name Name As Per IC/Passport

*Last Name

*Gender

*Race

*Date Of Birth

*New IC. No For New IC. No format 180101101818

Passport

*Phone Number Eg: 0312345678

*Email

Address

*Street

*City

*State / Province

*Post Code

*Country

T-Shirt Size

*T-Shirt Size

Contact Info

*First Name Name As Per IC/Passport

*Last Name

*Gender

*Race

*Date Of Birth Eg: 23 July 1989

*New IC. No For New IC. No format 180101101818

Passport

*Phone Number Eg: 0312345678

*Email

Address

*Street

*City

*State / Province

*Post Code

*Country

T-Shirt Size

*T-Shirt Size

Emergency Contact

*First Name

*Last Name

*Phone Number

Mandatory field *

I hereby agree not to hold the organizer and co-organizers, their representatives and sponsors against all cost, expense or liability that may arise in consequence of my participation in the event, I hereby waive all claims for any and all injuries, death and invalidity to me or the person under my care which may be caused by any act, or failure to act by the organizer, members and employees arising directly or indirectly during the course of event or arising as a result of it. In consideration of the organizer accepting this entry, I hereby assume liability for any loss, damage or liability from the above event. I confirm that I have read and accepted the conditions of entry to event and the rules and regulations for this event.