Given Name
|
|
Mika Nasri
|
Family Name
|
|
Marn Najmi
|
Nationality
|
|
Malaysia
|
IC No./Passport No.
|
|
130830102651
|
Date of Birth
|
|
08/30/2013
|
Gender
|
|
Male
|
Address 1
|
|
No 92, Jalan 2, Ampang Jaya
|
Post Code
|
|
68,000
|
State
|
|
Selangor
|
Country
|
|
Malaysia
|
Contact No. (ex: 6012345678)
|
|
60133425371
|
Email
|
|
haznita@yahoo.com
|
Event-T Size
|
|
Kids-M
|
Emergency Contact Number (ex: 6012345678)
|
|
60193843489
|
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 |
|
|