MABA Academy: HIGH LEVEL TRAINING by REGGIE STOVELL (21 & 22 July 2018)
Date of Birth
Phone number (01x-xxx xxxx)
List of any Medical Problems:
Parent/Guardian's Phone Number (01x-xxx xxxx)
Session 1 @ 21 July | 9:00 - 12:00 PM (RM50)
Session 2 @ 21 July | 2:00 - 5:00 PM (RM50)
Session 3 @ 22 July | 9:00 - 12:00 PM (RM50)
Session 4 @ 22 July | 2:00 - 5:00 PM (RM50)
ALL 4 Sessions @ 21 & 22 July (RM180)
Bank Account Details
Bank Name: CIMB Bank
Bank Account: 8008929817
Bank Account Name: Pro League Management Sdn Bhd
Venue: MABA Stadium, Jalan Hang Jebat, 50150, Kuala Lumpur, Wilayah Persekutuan, 50150
WAIVER AND RELEASE AS REQUIRED BY MALAYSIA BASKETBALL ASSOCIATION (MABA) FOR ALL PARTICIPANTS:
I hereby authorize any medical evaluation or treatment which may be advised or recommended by the attending physician of the participant name above while at the MABA Academy. In consideration of my application being accepted, intending to be legally bound, do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all claims for damages, which may or may not hereafter occur to me, against MABA or the Academy or their respective officers, agents, representatives, successors and/or assigns, for any or all damages which may be sustained or suffered by me or participation at the training venue. I, the parent or guardian, do hereby agree to the above waiver and release. I also grant the MABA and its Academy rights to use any photographs of activities in future promotional materials. I pledge his/her compliance to any and all academy rules and understand that he/she could be dismissed from the academy for any conduct not in the best interests of the academy or its participants and that no part of participant’s tuition fee will be refunded.
A copy of your responses will be emailed to the address you provided.
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