|
Given Name
|
| |
Johnathon
|
|
Family Name
|
| |
Loi Ming Jie
|
|
Nationality
|
| |
Malaysia
|
|
IC No./Passport No.
|
| |
131018081049
|
|
Date of Birth
|
| |
10/18/2013
|
|
Gender
|
| |
Male
|
|
Address 1
|
| |
97
|
|
Address Line 2
|
| |
Hala Pantai Baru Tiga,
|
|
Address Line 3
|
| |
Taman Pantai Baru, Pantai Remis
|
|
Post Code
|
| |
34,900
|
|
State
|
| |
Perak
|
|
Country
|
| |
Malaysia
|
|
Contact No. (ex: 6012345678)
|
| |
0123151570
|
|
Email
|
| |
senanginhobi@yahoo.com.my
|
|
Event-T Size
|
| |
Adults-S
|
|
Emergency Contact Number (ex: 6012345678)
|
| |
0123151570
|
|
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 Kids Duathlon
|
1 |
RM 50.00 |
RM 50.00 |
| |
Sub Total |
RM 50.00
|
| |
Total |
RM 50.00 |
|
