|
Given Name
|
| |
Boon Chong
|
|
Family Name
|
| |
Lee
|
|
Nationality
|
| |
Malaysia
|
|
IC No./Passport No.
|
| |
720623145739
|
|
Date of Birth
|
| |
06/23/1972
|
|
Gender
|
| |
Male
|
|
Address 1
|
| |
62, jln saujana 13
|
|
Address Line 2
|
| |
Tmn ampang saujana
|
|
Post Code
|
| |
68,000
|
|
State
|
| |
Selangor
|
|
Country
|
| |
Malaysia
|
|
Contact No. (ex: 6012345678)
|
| |
0123261828
|
|
Email
|
| |
gain2wealth@gmail.com
|
|
Event-T Size
|
| |
Adults-M
|
|
Emergency Contact Number (ex: 6012345678)
|
| |
0122731236
|
|
Agreement
|
| |
I agree to the privacy policy.
I have read and agree to abide by the Event Registration Rules & Regulations of Matrix Duathlon 2023.
|
|
Order
|
| |
| Product |
Qty |
Unit Price |
Price |
|
Matrix Duathlon Standard
|
1 |
RM 150.00 |
RM 150.00 |
| |
Sub Total |
RM 150.00
|
| |
Total |
RM 150.00 |
|
|