EmailMe Form - Beat My Trick 2012

Name *
First Last
IC No *
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
Category *
BMX Flatland Open
BMX Street Open
Skateboard Open
Skateboard Close (under 20)
Email *
T-Shirt Size
S
M
L
XL
XXL
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY. In consideration of organizer of this event, accepting my application to participate in this activity, I agree: To waive any and all claims I may have in future against the organizer and others involve
AUTHORISATION BY PARENTS/GUARDIAN OF PARTICIPANT UNDER 18 YEARS OLD
Parents/Guardian Name
Note

Registration fee : RM10.00 per person
Any Inquiries : 0169900804 (Rizal)
http://www.facebook.com/events/220157888075202/