R4N'16
What is NASAM? NASAM is an agency that provides rehabilitation services for stroke survivors to rebuild their lives as normally. It was established in 1996. Now, NASAM operates 7 rehabilitation centers around Malaysia. Faculty of Geoinformation and Faculty of Management Universiti Teknologi Malaysia ( UTM Skudai ) will hold a charity run to ease the burden of stroke patients and enlighten the public about the prevention of stroke. The event will be held as follows:

Date : May 14th 2016
Venue : Padang Kawad UTM

PAYMENT PROCEDURE:
1. Please TRANSFER or BANK IN to
i) Nur Afiqah binti Mohd Kamal 7609123565 (CIMB)
ii) Muhammad Nazrin bin Ismail 151306953435 (MAYBANK)

2. If you are using online banking, do fill alert recipient at run4nasam@gmail.com
3. After you are do the payment, SNAP THE BANK IN SLIP or BANK IN DETAILS as proof.
4. Extra payment will NOT be refund to your account bank.
5. Don't forget to fill out the details:
i) Bank Name
ii) Date & time
iii) Total paid
iv) Name as registration

Any enquiry, do contact us at +60196987396(Balqis), +0136828606(Ammar)

RACE KIT COLLECTION:
Venue : Padang Kawad, UTM
Date : 13 MAY 2016
Time : i) 1st session : 9.30 am - 11.30 am
ii) 2nd session : 3.00 pm - 5.00 pm
*NOTES : If you can't collect the race kit on the date above, the kit can be collected before the event started on 14 MAY 2016 at 7.00 am.

CLOSING DATE FOR REGISTRATION : 30 APRIL 2016

Terms and Conditions:
1. Organizer will not responsible in case of any serious accidents during the event.
2. For participants under the age of 18 is under the supervision of parent/ guardian.
3. For participants who experienced personal/chronic pain, responsibility is at your own risk. Organizer only provides basic medical.
4. All personal belongings at your own risk.
5. Fees: i)Student
Group : RM 100 (3 persons)
Individual : RM 35
ii) Non-student
Group : RM 120 (3 persons)
Individual : RM 45
iii) Stroke Survivor: RM20

6. For any cancellation, there is NO REFUND and considered as a donation to NASAM.
7. All information regarding the event will be informed through e-mail.
8. Participants must pay the registration fees right after the registration.
Name
Your answer
IC/ Passport number
Your answer
Address
Your answer
Contact Number
Your answer
Email
Your answer
Category
Shirt Size
Your answer
Matrix number (student only)
Your answer
College Residence (student only)
Your answer
Declaration
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms