MEGA BURN 60 - Participant Registration
Date: 1st September 2019 - 6th October 2019
Event Address: Physique Nation Fitness Centre Putrajaya & Melaka
Contact us at : 012 - 771 7678 or physiquenation.my@gmail.com
Email address *
Full Name as Per ID *
Your answer
IC/Passport Number *
Your answer
Email *
Your answer
Contact Number (Please type in +601xxxxxxxx) *
Your answer
Contesting Group *
Category group
Which branch will you attend? *
Required
Do you have any medical conditions? *
If Yes, please state your medical condition
Your answer
Emergency Contact Person *
Your answer
Emergency Contact Number *
Your answer
T-SHIRT SIZE *
I understand that I will have to pay RM350 upon Online registration. (15% discount for student and senior citizen) *
Required
Payment Method *
Online Transfer (Reference: Mega <Participants Name>)
QRPAY
POWERED BY PHYSIQUE NATION
PHYSIQUE WELLNESS - 002983547P (Formally known as GQ Fitness)
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