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Application form Hatyai MTB Jamboree 2012 27th May 2012. Start at 08.10 am. Closing Date: 8th May 2012. Name……………………………………………………..Family Name…………………………………………………... Date of Birth……………………………………
Gender…………………………….Age……………………………… Address………………………………………………………………………………………………………………………………………………………………………………………………….Postal Code………………………………………. ID Card Number……………………………………………………………………………………………………………. Phone…………………………………………………………. Email……………………………………………………… Team…………………………………………………………………………………………………. Category:
Male
16-50 years (…..)
More than 51 years (…..)
Female (…..)
Children
Male (…..)
Female (…..)
Person to contact in case of emergency Name…………………………………………………………………….Phone…………………………………………… Application Fee
800 Baht
[ 85 RM] (Arena Hatyai)
(…..)
Bike Shirt (Circle to specify)
S / M / L / XL / XXL Application Fee
2800 Baht
[ 280 RM] (3 arenas)
(…..)
T-shirt
(Circle to specify)
S / M / L / XL / XXL For email application, Thailand: transfer the fee to Krung Thai Bank, Nipatutit 2 Branch, Saving Account
TRACKZONE
Number 9150174878, Malaysia: transfer the fee to Bank Islam, Saving Account Mr. Pakorn
Pourpunsawat
Number 02093027539057 and send the receipt to me_tharin@hotmail.com or FAX: 074-240231
Legalized Remarks for participants with risks. The participants must be 18 years or older. Those under 18 must have consent from the guardian as shown below. Cautions
1. The bike must be checked by a technician to be in good condition for biking.
2. The participants need to have knowledge about and understand the challenging routes for biking as well as biking skills. Recommendations I recommend that the above is true. I have trained well and I am healthy. I am willing to join Hatyai MTB Jamboree 2012 and I will not request for any compensation in case of danger or hurt before/after or during biking. I am willing to show the evidence with date of birth and photo to prove to the committee and I agree to allow the committee record all the events to be under the copyright of Track Zone. I have read all the rules and regulations comprehensively. In case of accidents during biking, I will not request for any compensation. I recommend that all of the above is true. Sincerely, Sign……………………………………………….Applicant Date……./………./……... Sign………………………………………………Guardian Date……../……..../………. For the participants under 18, please attach the copy of ID Card or Student Card. Note:
Apply now to 8th May 2012
800
Baht
[ 85 RM]
Apply at the event on 26th May 2012
1000 Baht
[ 110 RM]
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发表于 9-4-2012 02:15 PM
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