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EF2019 Round 2 報名表
主辦單位: 中國香港綜合搏擊運動總會

請於2019年3月15日前填寫以下報名表
Please submit the online application form on/before 10th Dec, 2018.

Email address *
中文姓名 Chinese Name
以身份證為準 Same as HKID
英文姓名 English Name *
以身份證為準 Same as HKID
出生日期 Date of Birth *
MM
/
DD
/
YYYY
性別 Gender *
手提電話 Mobile *
代表團體名稱 Name of Team
身份證號相片 ID Card Photo
參加組別 Division *
報名費 $200 單據 Payment Receipt
參加賽例 Rule *
重量 Weight(kg) *
比賽往續 Fight Records *
4場或以上比賽經驗者請於「其他」選項中以格式填寫/ if you have 4 or above fight record please fill in as format :_____場/ Bouts ____勝/ W(___KO) ____負/ L ____和 /D
健康狀況 Health Declaration *
緊急聯絡人姓名 Name of Emergency Person *
緊急聯絡人電話 Emergency Contact *
本人同意並聲明上述所提交的資料根據本人所知及所信皆確實無誤,並明白所提交的資料將會記錄於MCSF資料庫內,若提交資料有虛假或誤導,將會被取消申請或參賽資格。 本人亦同意及聲明,若本人因(包括及不限於)健康、體能、個人技術、比賽合理情況下出現的狀況或其他原因,而所導致於比賽及訓練中引致的任何傷亡,概由本人負責,與主辦單位無關,主辦單位亦不會就該傷亡負責。 I certify the submitted information are correct, accurate and complete to the best of my knowledge and belief. In completing this form, I understand that if I wilfully or intentionally provide false and or misleading information, it will lead to disqualification for the applied competition. Information provide will be recorded in MCSF database. I acknowledged and shall take full responsibility for any injury or death which may sustain /arise directly or indirectly as a result of this activity. This included but are not exhausted to the following. E.g. health conditions, fitness level, technical errors and or any reasonable hazards that may arise within the competition. Our organization will not be held responsible and waive any liabilities on any personal injuries or death caused by the event. *
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