Registration Form [Learning Curve : Library Time Attack]
Event Date      : 30/11/2013 (Saturday)
Event Time      : 8 a.m.
Registration     : 8 a.m. - 9 a.m.
Event Place     : Perpustakaan Raja Tun Uda, Shah Alam
Event Fee        : RM 25


*Racer will not be able to choose T-Shirt Size (between M/L) for registration beyond 16 November 2013.
*Registered riders will pay the registration fee as stated above on the race day, on the morning of registration.
*For racers under 18 years of age, a permission letter that should be signed by your guardian will be sent to you.
Sign in to Google to save your progress. Learn more
1. Name
2. Date of Birth
3. Contact Number
4. Emergency Contact Name
5. Emergency Contact Number
6. Email (to receive waiver form)
7. T-Shirt Size
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report