Registration Form
Registration form for "Up-Close and Personal with Robin Lim" on 1 June 2013, by the Gentle Birthing Group Malaysia.

Please make payment to Maybank: 112353151706 Nadine Ghows or CIMB: 14560001665059 Ira Elza Uzair Yahaya BEFORE filling in this registration form.
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Full Name *
Full Name *
Email address *
Handphone number *
How did you hear about this event? *
Required
How many people will be attending this event? *
(excluding children)
Are you or your spouse currently expecting a child? *
Full amount paid *
(RM30 per person above 18 years)
Transaction number *
(if it was cash deposit, please state)
Date transaction was made *
Submit
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